Treatment planning

ABSTRACT

An example method includes: receiving, from a treatment planning process, information that is based on a dose distribution for an irradiation target; and performing at least one of the following operations: moving structures to trim spots of a particle beam so that the spots of the particle beam approximate pre-trimmed spots for which characteristics are obtained based on the information received; moving structures to produce a trimming curve for a layer of an irradiation target based on a specification of a trimming curve for the layer included in the information received; moving structures to produce a single trimming curve for all radiation fields of an irradiation target based on specifications of the single trimming curve included in the information received; or moving structures based on configuration information for the structures in the information received.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit of priority of U.S. ProvisionalApplication No. 62/360,227, which was filed on Jul. 8, 2016, and whichis entitled “Treatment Planning”. U.S. Provisional Application No.62/360,227 is incorporated herein by reference.

TECHNICAL FIELD

This disclosure relates generally to treatment planning in a particletherapy system.

BACKGROUND

Particle therapy systems use an accelerator to generate a particle beamfor treating afflictions, such as tumors. In operation, particles areaccelerated in orbits inside a cavity in the presence of a magneticfield, and are removed from the cavity through an extraction channel. Amagnetic field regenerator generates a magnetic field bump near theoutside of the cavity to distort the pitch and angle of some orbits sothat they precess towards, and eventually into, the extraction channel.A beam, comprised of the particles, exits the extraction channel.

The particle beam can damage healthy tissue adjacent to the irradiationtarget. A structure may be used to limit exposure of the healthy tissueto the particle beam. For example, the structure, or a portion thereof,may be placed in between the particle beam and the healthy tissue,thereby preventing exposure of the healthy tissue to the particle beam.

SUMMARY

An example method includes receiving, from a treatment planning process,information that is based on a dose distribution for an irradiationtarget; and configuring an adaptive aperture based on the information.The example method may include one or more of the following features,either alone or in combination.

The information received from the treatment planning process mayidentify structures of the adaptive aperture; and configuring theadaptive aperture may comprise moving the structures of the adaptiveaperture to produce a trimming curve. The information may identifycharacteristics of a trimming curve; and configuring the adaptiveaperture may comprise moving structures of the adaptive aperture toproduce the trimming curve. The information my identify characteristicsof pre-trimmed spots, which characteristics are stored in a library incomputer memory; and configuring the adaptive aperture may comprisemoving structures of the adaptive aperture to trim spots of a particlebeam so that the spots of the particle beam approximate the pre-trimmedspots. The information may indicate where spots are to be formed on theirradiation target; and configuring the adaptive aperture may comprisemoving structures of the adaptive aperture based on where the spots areto be formed on the irradiation target. The information may identifycharacteristics of spots; and configuring the adaptive aperture maycomprise moving structures of the adaptive aperture on a spot-by-spotbasis.

Configuring the adaptive aperture may comprise moving structures of theadaptive aperture so that at least two successive spots have at leastone of a different size or a different shape. The information maycomprise specifications of a trimming curve for a radiation fieldassociated with the irradiation target; and configuring the adaptiveaperture may comprise moving structures of the adaptive aperture toproduce the trimming curve. The specifications may identify at least oneof shape or a location of the trimming curve relative to a known point.The information may comprise specifications of distinct trimming curvesfor different layers of the irradiation target; and configuring theadaptive aperture may comprise moving structures of the adaptiveaperture to produce a trimming curve for each layer of the irradiationtarget based on specifications for the each layer.

The information received from the treatment planning process maycomprise specifications of a single trimming curve for a radiation fieldassociated with the irradiation target; and configuring the adaptiveaperture may comprise moving structures of the adaptive aperture toproduce the single trimming curve. The single trimming curve may be usedto trim a radiation field for multiple layers of the irradiation target.The information may comprise specifications for a configuration of theadaptive aperture for a radiation field of the irradiation target; andconfiguring the adaptive aperture may comprise moving structures of theadaptive aperture based on the specifications for the configuration ofthe adaptive aperture. The information may comprise specifications ofconfigurations of the adaptive aperture for different layers of theirradiation target; and configuring the adaptive aperture may comprisemoving structures of the adaptive aperture for the different layers ofthe irradiation target based on the information.

The adaptive aperture may comprise: structures that are movable relativeto the irradiation target to produce a shape to trim part of a treatmentarea; and a primary carriage coupled to the structures to move thestructures relative to the irradiation target in a first dimensionrelative to the irradiation target. Configuring the adaptive aperturemay comprise moving at least one of a structure among the structures orthe primary carriage. The adaptive aperture may comprise secondarycarriages coupled to the primary carriage and to the structures to movethe structures in a second dimension relative to the irradiation target.Configuring the adaptive aperture may comprise moving at least one ofthe secondary carriages. The second dimension may comprise movementinto, and out of, the treatment area. Moving at least one of thesecondary carriages may comprise rotating the at least one secondarycarriage. The structures may comprise leaves that are extendible andretractable relative to the particle beam. Configuring the adaptiveaperture may comprise rotating all or part of the adaptive aperture.

An example method comprises receiving, from a treatment planningprocess, information that is based on a dose distribution for anirradiation target; and performing at least one of the followingoperations: moving structures to trim spots of a particle beam so thatthe spots of the particle beam approximate pre-trimmed spots for whichcharacteristics are obtained based on the information received; movingstructures to produce a trimming curve for a layer of an irradiationtarget based on a specification of a trimming curve for the layerincluded in the information received; moving structures to produce asingle trimming curve for all radiation fields of an irradiation targetbased on specifications of the single trimming curve included in theinformation received; or moving structures based on configurationinformation for the structures in the information received. Thestructures may be part of an adaptive aperture and may comprise leavesthat are movable into, or out of, an area to be treated by the particlebeam. The information may specify a configuration of the leaves and/orcarriage(s) holding the leaves.

An example particle therapy system comprises: a particle accelerator tooutput a particle beam for application to an irradiation target; anadaptive aperture between the particle accelerator and the irradiationtarget, where the adaptive aperture comprises structures that aremovable into, and out of, a path of the particle beam; and a controlsystem comprising one or more processing devices configured to performvarious operations. The various operations may comprise: receiving, froma treatment planning process, information that is based on a dosedistribution for the irradiation target; and configuring the adaptiveaperture based on the information. The example particle therapy systemmay include one or more of the following features, either alone or incombination.

The information based on the dose distribution may identifycharacteristics of pre-trimmed spots, with the characteristics beingstored in a library in computer memory; and configuring the adaptiveaperture may comprise moving structures of the adaptive aperture to trimspots of a particle beam so that the spots of the particle beamapproximate the pre-trimmed spots. The information may indicate wherethe pre-trimmed spots are to be formed on the irradiation target; andconfiguring the adaptive aperture may comprise moving structures of theadaptive aperture based on where the pre-trimmed spots are to be formedon the irradiation target. The characteristics may comprise one or moreparameters, with the one or more parameters comprising at least one of aradius associated with a spot or an angle of rotation of the spot. Theinformation may identify characteristics of spots; and configuring theadaptive aperture may comprise moving structures of the adaptiveaperture on a spot-by-spot basis.

Configuring the adaptive aperture may comprise moving structures of theadaptive aperture so that at least two successive spots have at leastone of a different size or a different shape. Configuring the adaptiveaperture may comprise maintaining structures of the adaptive aperture sothat at least two successive spots have at least one of a same size or asame shape. The information may comprise specifications of a trimmingcurve for a radiation field associated with the irradiation target; andconfiguring the adaptive aperture may comprise moving structures of theadaptive aperture to produce the trimming curve. The specifications mayidentify at least one of shape or a location of the trimming curverelative to a known point.

The information based on the dose distribution may comprisespecifications of trimming curves for different layers of theirradiation target; and configuring the adaptive aperture may comprisemoving structures of the adaptive aperture to produce a trimming curvefor each layer of the irradiation target based on specifications for theeach layer. The information may comprise specifications of a singletrimming curve for a radiation field associated with the irradiationtarget; and configuring the adaptive aperture may comprise movingstructures of the adaptive aperture to produce the single trimmingcurve, with the single trimming curve being used to trim a radiationfield for multiple layers of the irradiation target.

The information may comprise specifications for a configuration of theadaptive aperture for a radiation field of the irradiation target; andconfiguring the adaptive aperture may comprise moving structures of theadaptive aperture based on the specifications for the configuration ofthe adaptive aperture. The information may comprise specifications ofconfigurations of the adaptive aperture for different layers of theirradiation target; and configuring the adaptive aperture may comprisemoving structures of the adaptive aperture for the different layers ofthe irradiation target based on the information. The adaptive aperturemay comprise a primary carriage coupled to the structures to move thestructures relative to the irradiation target in a first dimensionrelative to the irradiation target; and configuring an adaptive aperturemay comprise moving at least one of a structure among the structures orthe primary carriage. The adaptive aperture may comprise secondarycarriages coupled to the primary carriage and to the structures to movethe structures in a second dimension relative to the irradiation target;and configuring the adaptive aperture may comprise moving at least oneof the secondary carriages.

The second dimension may comprise movement into, and out of, thetreatment area. Moving at least one of the secondary carriages maycomprise rotating the at least one secondary carriage. The structuresmay comprise leaves that are extendible and retractable relative to theparticle beam. Configuring the adaptive aperture may comprise rotatingall or part of the adaptive aperture.

An example particle therapy system comprises: a particle accelerator tooutput a particle beam for application to an irradiation target; and acontrol system comprising one or more processing devices configured toperform various operations. The operations comprise receiving, from atreatment planning process, information that is based on a dosedistribution for the irradiation target; and performing at least one ofthe following operations: moving structures to trim spots of theparticle beam so that the spots of the particle beam approximatepre-trimmed spots for which characteristics are obtained based on theinformation received; moving structures to produce a trimming curve fora layer of an irradiation target based on a specification of a trimmingcurve for the layer included in the information received; movingstructures to produce a single trimming curve for all radiation fieldsof an irradiation target based on specifications of the single trimmingcurve included in the information received; or moving structures basedon configuration information for the structures in the informationreceived. The structures may be part of an adaptive aperture and maycomprise leaves that are movable into, or out of, an area to be treatedby the particle beam.

An example method that may be performed by a particle therapy systemcomprises obtaining a target dose distribution for a treatment area;identifying one or more pre-trimmed spots from among a library ofpre-trimmed spots that best approximates one or more points of thetarget dose distribution; and outputting information identifying the oneor more pre-trimmed spots. The example method may comprise one or moreof the following features either alone or in combination.

The example method may comprise obtaining a set of coarse spots thatapproximates the target dose distribution; changing an intensity of oneor more spots in the coarse set based on a maximum acceptable dosage fora portion of the treatment area; identifying a spot among the coarsespots that is within a transition region of the treatment area; andsubstituting the one or more pre-trimmed spots for the spot within thetransition region. The example method may comprise obtaining a minimumacceptable dosage for a portion of the treatment area; where the set ofcoarse spots is selected based on the minimum acceptable dosage. Theinformation may be usable to configure an adaptive aperture to achieve adose distribution during treatment that approximates the target dosedistribution.

An example method that may be performed by a particle therapy systemcomprises obtaining treatment planning information; determining that anirradiation target has moved since a prior application of radiationbased on the treatment planning information; modifying the treatmentplanning information based on movement of the irradiation target toproduce updated treatment planning information; and applying radiationto the irradiation target based on the updated treatment planninginformation. The example method may comprise one or more of thefollowing features either alone or in combination.

Modifying the treatment planning information may be performed by acomputing system of the particle therapy system. Determining that thatirradiation target has moved may be based on a comparison of images ofthe irradiation target captured between two points in time. Thetreatment planning information may be modified by changing locations towhich spots of radiation are to be applied to the irradiation targetbased on a location of the irradiation target following movement.

Two or more of the features described in this disclosure, includingthose described in this summary section, may be combined to formimplementations not specifically described herein.

Control of the various systems described herein, or portions thereof,may be implemented via a computer program product that includesinstructions that are stored on one or more non-transitorymachine-readable storage media, and that are executable on one or moreprocessing devices (e.g., microprocessor(s), application-specificintegrated circuit(s), programmed logic such as field programmable gatearray(s), or the like). The systems described herein, or portionsthereof, may be implemented as an apparatus, method, or electronicsystem that may include one or more processing devices and computermemory to store executable instructions to implement control of thestated functions.

The details of one or more implementations are set forth in theaccompanying drawings and the description below. Other features,objects, and advantages will be apparent from the description anddrawings, and from the claims.

DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of an example adaptive aperture leaf thatis usable with the example adaptive apertures described herein.

FIG. 2 is a top view of an example adaptive aperture leaves positionedrelative to a treatment area of an irradiation target.

FIG. 3 is a perspective view of an example adaptive aperture.

FIG. 4 is a front view of an example adaptive aperture having componentsportrayed in see-through to show the interiors thereof.

FIG. 5 is a perspective view of an example adaptive aperture havingcomponents portrayed in see-through to show the interiors thereof.

FIG. 6 is a top view of example control structures used to move a leafinto, and out of, a treatment area of an irradiation target.

FIG. 7 is a perspective view of an example adaptive aperture havingcurved leaves.

FIG. 8 is a cross-sectional view of an example synchrocyclotron for usein a particle therapy system.

FIG. 9 is a cross-sectional view of an example synchrocyclotron for usein a particle therapy system.

FIG. 10 is a side view of an example scanning system.

FIG. 11 is a perspective view of components of an example scanningsystem.

FIG. 12 is a front view of an example magnet for use in a scanningsystem of the type shown in FIGS. 10 and 11.

FIG. 13 is a perspective view of an example magnet for use in a scanningsystem of the type shown in FIGS. 10 and 11.

FIG. 14 is a perspective view of an example energy degrader (rangemodulator) for use in a scanning system of the type shown in FIGS. 10and 11.

FIG. 15 is a perspective view of a process for moving a leaf of anenergy degrader in the path of a particle beam.

FIG. 16 is a perspective view of an adaptive aperture positionedrelative to a patient during particle therapy treatment.

FIG. 17 is a flowchart showing an example process for performing rasterscanning that may be performed using the hardware of FIGS. 10 to 15.

FIG. 18 is a top view show an example cross-section of an irradiationtarget and a radiation scan path.

FIG. 19 is a perspective view of an example therapy system.

FIG. 20 is an exploded perspective view of components of an examplesynchrocyclotron for use in the particle therapy system.

FIG. 21 is a cross-sectional, top view of the example synchrocyclotron.

FIG. 22 is a perspective view of the example synchrocyclotron.

FIG. 23 is a cross-sectional view of an example ion source for use inthe synchrocyclotron.

FIG. 24 is a perspective view of an example dee leaf and an exampledummy dee for use in the synchrocyclotron.

FIG. 25 is a conceptual view of an example particle therapy system thatmay use a variable-energy particle accelerator.

FIG. 26 is a perspective, exploded view of an example magnet system thatmay be used in a variable-energy particle accelerator.

FIG. 27 is an example graph showing energy and current for variations inmagnetic field and distance in a particle accelerator.

FIG. 28 is a side view of an example structure for sweeping voltage on adee leaf over a frequency range for each energy level of a particlebeam, and for varying the frequency range when the particle beam energyis varied.

FIG. 29 is a top view of example adaptive aperture leaves on carriagesmounted on a track that is curved relative to the direction of aparticle beam.

FIG. 30 is a top view of example adaptive aperture leaves positionedrelative to a treatment area of an irradiation target.

FIG. 31 is a graph showing an Gaussian distribution of a spot producedby the example particle therapy system.

FIG. 32 depicts an original spot and a pre-trimmed spot produced bytrimming the original spot.

FIG. 33 is a perspective view of an irradiation target containing layersto be treated by particle therapy.

FIG. 34 is a perspective view of an irradiation target containing layersto be treated, and application of a trimming curve to the irradiationtarget.

FIG. 35 is perspective view of a layer of an irradiation target andtrimming curves superimposed thereon.

FIG. 36 is a flowchart showing an example scanning process that includesconfiguring trimming curves based on information about a target dosedistribution.

FIG. 37 is a flowchart showing an example of an optimization processperformed to model, and to obtain, treatment plan information.

FIG. 38 is a side view of an example treatment area that identifiesdosage to be applied to the treatment area.

FIG. 39 is a side view of a coarse set of spots to be applied to thetreatment area.

FIG. 40 is a side view of the set of spots of FIG. 39, with a spothaving been intensity modulated.

FIG. 41 is a side view of the set of spots of FIG. 40, with a spothaving been replaced by a pre-trimmed spot.

FIG. 42 shows side views of example spots in a library.

FIG. 43 is a flowchart showing an example process for configuring anadaptive aperture in response to movement of an irradiation target.

Like reference symbols in the various drawings indicate like elements.

DETAILED DESCRIPTION

Described herein are example implementations of an adaptive aperture(also called a “configurable collimator”) that may be used to controlthe extent of radiation, such as a proton or ion beam, applied to apatient. In some implementations, an adaptive aperture includesstructures that are controllable to allow some radiation to pass to apatient and to block some radiation from passing to the patient.Typically, the radiation that passes is directed to an irradiationtarget to be treated, and the radiation that is blocked would otherwisehit, and potentially damage, healthy tissue. Radiation internal to thetarget may be blocked as well in order to achieve a target dosedistribution. In an example operation, the adaptive aperture is placedin the radiation path between a radiation source and an irradiationtarget and is controlled to produce a trimming curve of an appropriatesize and shape. A trimming curve may be an open-ended curve or a closedcurve, such as an opening that allows some radiation to pass to theirradiation target, while preventing some radiation from reachingadjacent tissue. The adaptive aperture may be used in any appropriateradiation therapy system, and is not limited to use with any particulartype of system, including those described herein. Examples of systemswith which the adaptive aperture may be used are described herein.

In some implementations, the adaptive aperture contains generally flatstructures, which are referred to as “plates” or “leaves”, and which arecontrollable to move into the “beam” or “treatment” area to block someradiation and allow some radiation to pass. The leaves are controllableto produce an opening of size and shape that is appropriate for thecurrent treatment. In some implementations, the leaves are held on twocarriages, and face each other and the treatment area. The leaves arecontrollable to move into, and out of, the treatment area, to form theopening (or aperture) though which the particle beam passes to treat anarea of a patient. The leaves that form the opening also block radiationfrom passing to tissue (e.g., healthy tissue) adjacent to the openingthat is covered by the leaves. In this context, covering includes theleaves blocking the particle beam. The leaves, or a portion thereof, maybe placed in between the particle beam and target tissue to create sharpdose gradients which may better optimize the dose distribution tosatisfy an objective function when combined with other particle beams.

In some implementations, each set of leaves is configurable to define anedge that is movable into a path of the particle beam so that a firstpart of the particle beam on a first side of the edge is blocked by theleaves, and so that a second part of the particle beam on a second sideof the edge is not blocked by the leaves and is allowed to pass to thetreatment area. In some implementations the leaves are connected to, arepart of, or include, motors—one per leaf—that are controllable tocontrol movement of the leaves towards or away from the treatment areato define the edge. In some implementation, the motors may be linearmotors. An example linear motor includes a movable component and astationary component. The stationary component may include a magneticfield generator, such as two magnets having their poles aligned, togenerate a first magnetic field. The movable component may be sandwichedbetween the two magnets and may include one or more coils to conductcurrent to produce a second magnetic field that interacts with the firstmagnetic field to cause the moveable component to move relative to thestationary component. The movable component of each linear motor isconnected to, or part of, a corresponding one of the leaves such thatthe corresponding leaf moves along with movement with the movablecomponent.

FIG. 1 shows an example of a leaf 40 that may be used in the adaptiveaperture, although the adaptive aperture is not limited to use with thistype of leaf. The height 50 of the leaf is along the beamline (e.g., thedirection of the particle beam). The length 52 of the leaf is along itsdirection of actuation into and out of the treatment area, and is basedon the field size, or portion thereof, that the system can treat. Thefield size corresponds to the treatment area that the beam can impact.The width 53 of the leaf is the direction along which multiple leavesstack when actuated. Generally, the more leaves that are used, thehigher the resolution of the trimming curve that can be produced,including for curved boundaries.

In FIG. 1, leaf 40 includes a tongue and groove feature 55 along itsside, which is configured to reduce inter-leaf leakage when multiplesuch leaves stack. In this example, the curved end 56 of leaf 40 isconfigured to maintain a surface tangent to the beam at all locations inthe treatment area. However, in some implementations, the end of eachleaf may be flat, not curved.

In some implementations, the adaptive aperture leaves have a height thatis sufficient to block at least the maximum beam energy (e.g., themaximum energy of the particle beam output by a particle therapysystem). In some implementations, the adaptive aperture leaves have aheight that blocks less than the maximum beam energy, for reasonsdescribed below. In some implementations, the adaptive aperture leaveshave lengths that are dictated not by the area of an entire treatmentarea, but rather by the area of a single beam spot or multiple beamspots. In this context, a “beam spot” includes the cross-sectional areaof a particle beam. In some implementations, the adaptive aperture iscontrollable to move into the “beam” or “treatment” area to block someradiation and allow some radiation to pass from an individual ormultiple beam spot(s).

In an example, the particle therapy system may be configured to treat atumor having a cross-section that can fit into a 20 cm×20 cm squarearea. In this example, each leaf in the adaptive aperture may have alength of about 2 cm, which is about enough to block particles in halfof one beam spot. As noted, the adaptive aperture may include sets ofleaves that face each other. So, leaves from each set may be controlledto cover the whole, single beam spot, if necessary, thereby preventingpassage of radiation. The leaves may also be controllable to create oneor more trimming curves that define an opening through which some, orall, of the radiation from the single beam spot can pass.

In operation, the adaptive aperture is configured to move as the beamscans across the radiation target, and to track the beam's movementduring scanning. In an example, the adaptive aperture may be configuredto move about 20 cm so as to enable coverage over the entirety of the 20cm×20 cm area. As described above, the adaptive aperture may beconfigured to use enough leaves to cover (or “trim”) one beam spot and,in some case, a small amount of extra area (e.g., 5% extra area, 10%extra area, 15% extra area, or 20% extra area).

FIG. 2 shows an example implementation of an adaptive aperture 700. Inthis example, adaptive aperture 700 includes leaves 701 having a heightand made of a material, such as nickel, brass, tungsten, or other metal,sufficient to inhibit or prevent passage of radiation at a given energy.For example in some systems, a particle accelerator is configured togenerate a particle beam having a maximum energy of 100 MeV to 300 MeV.Accordingly, in such systems, the leaves may be constructed to preventpassage of a beam having an energy of 100 MeV, 150 MeV, 200 MeV, 250MeV, 300 MeV, and so forth.

Leaves 701 are mounted on carriages to control their movement relativeto a treatment area of an irradiation target, such as a cross-sectionallayer of a tumor in a patient. The movement is controlled to causeleaves 701 to cover some parts of treatment area 704, thereby preventingradiation from impacting those parts during treatment, while leavingother parts of treatment area exposed to the radiation. In the exampleimplementation of FIG. 2, there are fourteen leaves in total—seven onthe left and seven on the right. In some implementations, there may be adifferent number of leaves, e.g., ten in total, five on the left andfive on the right, twelve in total, six on the left and six on theright, and so forth.

The adaptive aperture may be used with any appropriate type of radiationtherapy system. In an example implementation, the radiation therapysystem is a proton therapy system. As described herein, an exampleproton therapy system scans a proton beam across a treatment area of anirradiation target in order to destroy malignant tissue. Duringscanning, the particle beam moves across the treatment area to cover thetreatment area with radiation. In an example implementation, theparticle beam is pulsed. Even with pulsed beams, uniform dose coveragecan be achieved with a single pass of the beam. Each spot may be hitwith multiple pulses to account for random variability in the intensityof each pulse that cannot be controlled. The particle beam may be passedover the treatment area multiple times in order to mitigate organ motioneffects due to patient motion (e.g., due to breathing). As a result, itmay be beneficial to scan the same treatment area more than once. Eachsuccessive scan may be offset from one or more other scan(s). An exampleof this type of scanning is called pencil-beam scanning, and therepetitive scans are referred to as painting or repainting the treatmentarea.

The irradiation target is typically three-dimensional in structure.Accordingly, as described herein, the irradiation target is treatedcross-sectional layer (or simply “layer”) by layer. That is, a layer ofthe irradiation target is treated, followed by another treatment ofanother layer, and so forth until the entire target is treated.Different layers of an irradiation target are treated by varying anenergy level of the particle beam. That is, different energy levels ofthe particle beam impact different layers of the irradiation target,with higher energy levels affecting layers deeper inside the irradiationtarget relative to the particle beam source. Accordingly, duringtreatment, the energy level of the particle beam is changed in order toreach, and thus treat, different layers of the irradiation target.

FIG. 2 shows leaves 701 configured to allow radiation to impact part ofa layer (e.g., the treatment area) and to prevent radiation fromimpacting other parts of the layer (e.g., healthy tissue). In FIG. 2,locations 707 represent centers of beam spots to be delivered during ascan of a proton beam across treatment area 704. Circle 708 represents atreatment boundary beyond which no radiation is intended to bedelivered. Beam spots that are close to this boundary (e.g., within onestandard deviation of the particle beam's profile) border healthytissue. These are spots that are trimmed (that is, blocked) byappropriate configuration and placement of leaves on the adaptiveaperture. An example of a beam spot to be trimmed is beam spot 711,having its center at location 706. As shown, ones of leaves 701 areconfigured to block the portion of beam spot 711 that extends beyondcircle 708.

In an example implementation, on each of two separate carriages, thereare five leaves that are about 5 mm in width and two leaves that areabout 20 mm in width, for a total of seven leaves per carriage. Thus, insome implementations, on each of two separate carriages, there are sevenleaves, two of which each have widths that are three times or more thewidths of each of five other leaves. Other implementations may containdifferent numbers, sizes, and configurations of leaves, and differentnumbers and configurations of carriages. For example, someimplementations may include any number between five and fifty leaves percarriage, e.g., 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19,20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37,38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, or 50 leaves (or more)per carriage.

The carriages can move both horizontally and vertically, as describedherein. The leaves are also movable horizontally relative to eachcarriage into, and out of, the treatment area. In this way, the leavesare configurable to approximate the shape of the treatment boundary inthe region near the area being treated (e.g., circle 711 or a portionthereof in this example).

The leaves may be moved vertically and/or horizontally between differentscans of the particle beam so that the leaves are in appropriatepositions when the beam is delivered to a particular area. The leavesneed not necessarily be moved for every scan pass, but instead may bemoved to a location appropriate for an area. In some cases, e.g., forspots interior to the treatment area, radiation treatment may proceedwithout the trimming provided by the adaptive aperture.

FIG. 30 shows another example of leaves 1400 that are part of anadaptive aperture configured to trim a radiation spot 1401 centered atlocation 1402. In this example, there are seven leaves on each of twosides of the adaptive aperture (supported by corresponding carriages).The leaves on each side include two leaves that are wider than the otherfive; however, the adaptive aperture is not limited to thisconfiguration. In this case, spot 1401 has a radius of 2.5 sigmadefining an 8 mm Gaussian radiation spot.

FIGS. 3, 4, and 5 show an example implementation of components of anexample implementation of an adaptive aperture, including carriages 713,714, 715 configured to hold, and to move, the leaves described aboveboth vertically and horizontally relative to the treatment target. Asshown, vertical movement includes movement in the Cartesian Z-dimension717, and horizontal movement includes movement in the CartesianX-dimension 718 (with the Cartesian Y-dimension being into, or out of,the page in FIG. 4). FIGS. 4 and 5 show parts of carriage housings astransparent in order to show components inside the housings; however,the housings are not actually transparent.

Carriage 713 is referred to herein as the primary carriage, andcarriages 714 and 715 are referred to herein as secondary carriages.Secondary carriages 714, 715 are coupled to primary carriage 713, asshown in FIGS. 3 to 5. In this example, secondary carriages 714, 715each include a housing that is fixed to primary carriage 715 via acorresponding member 718, 719. In this example, primary carriage 713 ismovable vertically (the Z-dimension) along tracks 720. The verticalmovement of primary carriage 713 also causes the secondary carriages tomove vertically. In some implementations, the secondary carriages movevertically in concert. In some implementations, vertical movement ofeach secondary carriage is independent of vertical movement of the othersecondary carriage.

As shown in FIGS. 3 to 5, each secondary carriage 714, 715 is connectedto a corresponding rod 722, 723, along which the secondary carriagemoves. More specifically, in this example, motor 725 drives secondarycarriage 714 to move along rod 722 towards or away from secondarycarriage 715. Likewise, in this example, motor 726 drives secondarycarriage 715 to move along rod 723 towards or away from secondarycarriage 714. Control over movement of the primary and secondarycarriages is implemented to position the leaves relative to theirradiation target, as described herein. In addition, the leavesthemselves are also configured to move in and out of the carriages, asalso described herein.

As shown in FIG. 5, a motor 730 drives the vertical movement of primarycarriage 713. For example, as shown in FIG. 4, lead screw 731 is coupledto housing 732, which holds motors 725, 726 that drive correspondingsecondary carriages 714, 715, and which is mounted on tracks 720. Leadscrew 731 is coupled to, and driven in the Z-dimension by, motor 730.That is, motor 730 drives lead screw 731 in the Z-dimension. Becauselead screw 731 is fixed to housing 732, this movement also causeshousing 732, and thus secondary carriages 714, 715, to move along tracks720 in the Z-dimension.

In this example implementation, as noted, seven leaves 735, 736 aremounted on each secondary carriage 714, 715. Each secondary carriage maybe configured to move its leaves horizontally (in the X-dimension) into,or out of, the treatment area. The individual leaves on each secondarycarriage may be independently movable in the X-dimension relative toother leaves on the same secondary carriage. In some implementations,the leaves may also be configured to move in the Y-dimension.Furthermore, the leaves on one secondary carriage 714 may be movableindependently of the leaves on the other secondary carriage 715. Theseindependent movements of leaves on the secondary carriages, togetherwith the Z-dimension movements enabled by the primary carriage, allowthe leaves to be moved into various configurations. As a result, theleaves can conform, both horizontally and vertically, to treatment areasthat are arbitrarily shaped both in horizontal and vertical dimensions.The sizes and shapes of the leaves may be varied to create differentconformations.

The leaves may be made of any appropriate material that prevents orinhibits transmission of radiation. The type of radiation used maydictate what material(s) are used in the leaves. For example, if theradiation is X-ray, the leaves may be made of lead. In the examplesdescribed herein, the radiation is a proton or ion beam. Accordingly,different types of metals or other materials may be used for the leaves.For example, the leaves may be made of nickel, tungsten, lead, brass,steel, iron, or any appropriate combinations thereof. The height of eachleaf may determine how well that leaf inhibits transmission ofradiation.

In some implementations, the leaves may have the same height, whereas inother implementations, some of the leaves may have heights that aredifferent from heights of others of the leaves. For example, in FIGS. 2to 5, the leaves are each 5 mm in height. However, any appropriateheights may be used. For example, leaves 735, 736 may have any of thefollowing (or other heights): 1 mm, 2 mm, 3 mm, 4 mm, 5 mm, 6 mm, 7 mm,8 mm, 9 mm, 10 mm, 11 mm, 12 mm, 13 mm, 14 mm, 15 mm, 16 mm, 17 mm, 18mm, 19 mm, 20 mm, 21 mm, 22 mm, 23 mm, 24 mm, 25 mm, 26 mm, 27 mm, 28mm, 29 mm, and so forth. The leaves may have any combination of theforegoing heights. In addition, each of the leaves may have a differentheight than one or more others of the leaves.

In some implementations, leaves of the same width or of varying widthsmay be stacked to inhibit radiation transmission. In someimplementations, thinner leaves (e.g., leaves of lesser width) may beused in connection with thicker leaves (e.g., leaves of greater width).In some implementations, the leaves have enough height to completelyblock the particle beam at the maximum beam energy. Leaves of the sameheight or of varying heights may be stacked to inhibit radiationtransmission. In some implementations, shorter leaves (e.g., leaves oflesser height) may be used in connection with longer leaves. In someimplementations, the leaves have enough height to completely block theparticle beam at the maximum beam energy. In some implementations, theleaves have enough height to block the particle beam at less than themaximum beam energy (and not to block the particle beam at maximumenergy). For example, while a proton therapy system may have thecapability to deliver a beam of energy 230 MeV that can treat to a depthin the patient of 32 cm, in some implementations, the adaptive aperturecan only block protons of at most 175 MeV that can treat to a depth ofno more than 20 cm. In doing so, less beam-stopping material may beused, e.g., 2.1 cm of Tungsten instead of 3.3 cm, or 3.3 cm of Nickelinstead of 5.2 cm. In this example, the proton therapy system wouldstill be capable of treating at depths exceeding 20 cm, but the adaptiveaperture would not be used for such treatments. This may be deemedacceptable because, in some circumstances, deeper treatments benefitless from the particle beam collimation that the adaptive apertureprovides. That is, in some treatment scenarios, shallow, low-energytreatments are where the adaptive aperture will be most effective, andthere may be engineering advantages to reducing the amount of materialin the leaves. Thus, in some example implementations, shorter leaves areused and the adaptive aperture is restricted to use with shallow,lower-than-maximum energy treatments.

In the implementations of FIGS. 2 to 5, the leaves are semi-rectangularin shape and have about the same surface area when viewed from the side.In some implementations, this need not be the case. For example, theleaves may have different shapes than those shown. Example shapesinclude, but are not limited to, circular shapes, curvilinear shapes,oval shapes, square shapes, and triangular shapes. Furthermore,individual leaves may have different shapes than others of the leavescontained in the same carriage or in a different carriage. For example,one carriage may contain both rectangular and curvilinear shaped leaves.

In some implementations, the leaves have heights that are enough notonly to fully stop a particle beam at the maximum expected proton energy(e.g., 3.3 cm of Tungsten at 230 MeV or, e.g., 5.2 cm of nickel), butalso to have enough extra material to prevent proton transmissionbetween the leaves. This material may have a tongue and groove structureas shown in FIG. 1, or a similar configuration. The leaf ends may beconfigured to include curved or tapered surfaces to enhance deliveredpenumbra for proton beams of various divergence.

In some implementations, there may be more than one primary carriage andcorresponding motors and rails. For example, a first primary carriagemay control Z-dimension movement of a first secondary carriage, and asecond primary carriage may control Z-dimension movement of a secondsecondary carriage. Therefore, in such implementations, the twosecondary carriages can be moved independently in the Z-dimension, ifdesired. In any case, the primary carriage may be computer controlled.For example, executable instructions are stored in computer memory(e.g., one or more non-transitory machine-readable storage media), andexecuted by one or more processing devices to control the movement.Control may be performed with, or without, user input during treatment.

As explained, each secondary carriage 714, 715 includes a correspondingmotor to control X carriage movement, as described above. In someimplementations, there may be also one motor for each leaf, whereas inother implementations a single motor may control all leaves. The motorsmay be mounted on a corresponding secondary carriage. As a result, themotors move along with the corresponding secondary carriage. As noted,the motors control movement of leaves in each carriage. The leaves maybe mounted on actuators that enable movement in two dimensions. In theexamples of FIGS. 2 to 5, the leaves are each part of an integratedleaf. Referring to the example of FIG. 6, mechanisms enable theindividual leaves to move in and out (the X-dimension) of the integratedleaf that comprises each carriage into, or out of, the treatment area.

In some implementations, all leaves on a single carriage areindependently movable. FIG. 6 shows the movement mechanism for a leaf735 a that is part of a secondary carriage. Each leaf in each secondarycarriage may have a configuration, and movement mechanism, that issimilar to, or identical to, the leaf and movement mechanism of FIG. 6.

In the example of FIG. 6, the movement mechanism includes a leaf stick735 b, a lead screw nut 735 c, a lead screw 735 d, a thrust bearingassembly 735 e, a coupling 735 f, a motor 735 g, a bearing block 735 h,a sleeve bearing pin 735 i, a sleeve bearing 735 j, and a motor mountblock 735 k. In operation the motor shaft, through the coupling, spinsthe lead screw. This causes the lead screw nut to advance or retractdepending on the direction of screw rotation. The lead screw nut isfixed to the leaf assembly so the leaf is moved forward or backward(into or out of the beam path) as the motor spins. Sleeve bearing pinsare fixed to the leaf and slide along sleeve bearings which are heldcaptive in the bearing block that supports the whole assembly. Thisbearing block houses the bearings and provides space for the motorassemblies for all leaves on the carriage.

In some implementations, the motors described with respect to FIG. 6 maybe replaced with linear motors. In some implementations, the linearmotors are controllable to configure a set of leaves to define a firstedge, and to configure another set of leaves to define a second edgethat faces the first edge. Each of the linear motors may include amovable component and a stationary component. The stationary componentmay include a magnetic field generator to generate a first magneticfield. An example of a magnetic field generator includes two stationarymagnets that are adjacent and spaced apart, and that have their polesaligned. The movable component includes one or more coils to conductcurrent to produce a second magnetic field that interacts with the firstmagnetic field to cause the moveable component to move relative to thestationary component. For example, the movable component may be acoil-carrying plate between the two magnets that make up the stationarycomponent. When current passes through the coil, that current produces amagnetic field that interacts with the magnetic field produced by thetwo magnets, and that causes the movable component (e.g., thecurrent-carrying plate) to move relative to the two magnets. In someimplementations, a single linear motor may control a single leaf.Because a leaf is attached to the movable component, the leaf movesalong with the movable component. The linear motors of different leavesmay be controlled to control movement of the leaves, and thus to definethe edges of the adaptive aperture described herein.

As described, the adaptive aperture can be used to trim each layer of ascanned treatment with a different aperture shape, allowing forthree-dimensional field shaping techniques such as layer stacking.However, an implementation of the adaptive aperture may be configured tomimic either a machined patient-specific structure or a multi-leafcollimator.

In this regard, some existing treatment planning systems (TPSs) performtreatment planning treatment planning processes that calculate the shapeof a fixed brass aperture meant to be uniformly applied to the entiretreatment volume. TPSs may also dictate, or contain instructions toconfigure, an adaptive aperture shape for a target. A computer programcan interpret an aperture shape, either from a continuous aperture curveor set of fixed multi-leaf collimator leaf positions, and translate thatshape into a series of dynamic leaf positions for the adaptive aperturethat correlate with delivered radiation treatment spots. Existing TPSfunctionality can thus be leveraged, allowing the adaptive aperture tobe compatible, with relatively few modifications, to existing TPSsoftware.

Another example technique that may improve edge conformality and that isenabled by the adaptive aperture takes advantage of the possibility thata treatment dose to the same treatment area of a layer will be deliveredin several passes or paintings. Repainting, which is described herein,is a technique used in scanned proton therapy in which dose is dividedto a treatment area using several particle beam passes in order tospread the delivered radiation uniformly during a timescale that is longcompared with patient motion, such as breathing. There are also otherreasons in which dose to a given spot may not all be delivered in onepulse. Some example reasons include: dynamic dose control can regulatethe charge in each pulse to deliver an accurate total dose, there aresafety limits to the charge in a pulse, and a required dynamic range ofdose may exceed the capabilities of the particle accelerator.

If the spots in an irradiated volume will be painted several timesduring a treatment (e.g., during multiple scans), then the conformalityof the adaptive aperture to the lateral edge of the irradiation targetcan be improved by shifting the leaves slightly (e.g., at thesub-millimeter level), vertically, horizontally, or both vertically andhorizontally between each painting (e.g., between each scan pass of theparticle beam covering a same treatment area). In this way, what mighthave been a slightly jagged edge owing to the finite size of theindividual leaves can be smoothed to attain a better approximation ofthe intended aperture curve.

Adding rotational degrees of freedom can improve the ability of theadaptive aperture to conform to radiation targets. For example, theentirety of the assembly of FIGS. 3 to 5 may be configured to be rotatedin a plane perpendicular to the beam direction, in a plane parallel tothe beam direction, or in a combination thereof. In someimplementations, each individual secondary carriage 714, 715 may beconfigured to rotate independently in a same plane. In this way, theadaptive aperture may provide more flexibility to conform to complexshapes that are not ideally oriented. In some implementations, both theprimary carriage and each secondary carriage may be rotatable.

In the example implementations described above, each leaf isindependently actuated such that an arbitrary shape can be traced with aleaf configuration. It may be, however, that such flexibility is notrequired to achieve acceptable edge conformality. The leaves could bemechanically constrained with the ability to achieve only a finitenumber of configurations. For example, the leaves could be restricted toarrangements that put them in a vertical line, forward diagonal shape,backward diagonal shape, concave shape, convex shape, or any otherachievable shape. In this way, flexibility could be traded formechanical simplicity. The leaves may be actuated using a cam timinggear through one remote motor rather than four motors mounted on asecondary carriage. In some implementations, discrete shapes of thegears may be machined out of sectors of wheels which are rotated intoplace as needed. In order to reduce the number of motors, feedback,controllers, and associated wiring, an assembly may be used that has onemotor that achieves discrete leaf configurations.

FIG. 7 shows an example implementation of an adaptive aperture havingcams that are rotatable relative to shaft 751. In the example of FIG. 7,all leaves 750 are actuated by one motor. This motor is at the top ofvertical shaft 751. The shape and orientations of leaf cams are chosento achieve different leaf configurations for different rotational anglesof the main drive shaft.

Another possible advantage of the adaptive aperture is the ability tocollimate edges that are completely internal to the field. If atreatment plan calls for a volume to be treated that completelysurrounds a volume to be protected—for example, a tumor that completelysurrounds a spinal cord—a single, machined structure will typically beunable to block radiation to the protected volume without blocking someof treated volume as well. The adaptive aperture can treat such a fieldusing a sequence of leaf positions. For example, the adaptive aperturecan be reconfigured dynamically, and during treatment, to protect theareas that require protection, while allowing treatment on areas thatrequire treatment.

In some cases, better beam performance (penumbra or edge sharpness)results when the particle beam is tangent to the surface of a leaf edge.However, since the beam effectively originates from a single pointsource, the angle with which it passes through the plane of the adaptiveaperture changes as the beam is moved away from the center of the field.For this reason, leaves may have curved edges, as shown in FIG. 1, sothat the edges can always be placed a location that makes them tangentto the particle beam. In an example implementation of the adaptiveaperture, the tracks on which both primary and secondary carriages moveare curved so that flat leaf edges can be used in lieu of curved leafedges, and so that the flat but remain tangent to the particle beam.

FIG. 29 shows an example implementation of a curved track 1420. In theexample of FIG. 29, the particle beam 1421 originates from source 1422,which may be a particle accelerator like the synchrocyclotron describedherein. Particle beam 1422 may scan through field 1423 and, at oneextent, may be at location 1425 and, at another extent, may be atlocation 1426. Carriages holding leaves 1428 and 1429 are mounted oncurved track 1420 so that leaves 1428 and 1428 can move towards or awayfrom each other. In this example, the leaves have straight ends (or“fronts”) 1431, 1431 in contrast to curved end 56 of FIG. 1. Byemploying a curved track, the particle beam can remain tangent, orsubstantially tangent, to the straight ends throughout the scan field1423. Keeping the particle beam tangent to the ends can be advantageousin that it enables the trimming provided by the adaptive aperture to beconsistent throughout the range of the beam field.

To summarize, in some implementations, the adaptive aperture may trimonly a small fraction of a treatment area at one time, e.g., an areathat is less than the entire treatment area and that is about equal toone spot size, two spot sizes, three spots sizes, four spot sizes, fivespot sizes, and so forth. Thus, in some implementations, the adaptiveaperture may be small enough to trim a single spot at once and may belarge enough to trim several spots in one position, but not the entirefield without moving. The adaptive aperture may be configured to movearound and within the field as the beam scans. For example, in someimplementations, the adaptive aperture tracks the beam as it scans, andits configuration and reconfiguration may be synchronized to thescanning and to the pulses provided by the beam (e.g., differentreconfigurations for different beam pulses and/or locations). By notusing leaves large enough to trim an entire treatment area, the adaptiveaperture can be made smaller and therefore the adaptive aperture can beplaced closer to the patient with little or no interference from otherdevices. In some implementations, no leaf of the adaptive aperture evenhas one dimension that spans an entire maximum treatment area. In someimplementations, each individual leaf is movable in two dimensionswithin the treatment area, and the device is mounted on a gantry (e.g.,in the context of a particle therapy system such as that describedherein) to be rotated on one or more axes and made extendable towardsand away from isocenter.

Example treatment planning processes are described in the context of asystem, such as that described herein, that contains an adaptiveaperture. The example treatment planning processes described below,however, are not limited to use with the systems described herein, andmay be used with any appropriate system that applies radiation to atarget, such as a tumor, for treatment.

An example treatment planning process (TPP) performed by a TPS mayemploy inverse planning. Generally, inverse planning includes obtaininga target dose distribution of radiation, and then performing a process,such as an optimization process, to determine characteristics thattogether achieve the target dose distribution. The process may beperformed by executing, on one or more processing devices, one or morecomputer programs that are stored on, and retrieved from, one or morenon-transitory machine-readable storage media. The characteristics mayinclude, but are not limited to, spot size, spot shape, spot location,spot weight (the number of protons per spot), spot orientation, and soforth. In some implementations, the characteristics may includeinformation relating to the construction of the adaptive aperture, e.g.,the numbers and locations of its leaves, the spot resolution that can beachieved using the adaptive aperture, the ways and extents that thecarriages can be moved, and so forth. In such examples, the TPSleverages its knowledge of the structure of the adaptive aperture toproduce instructions to the adaptive aperture to control itsconfiguration.

As described herein, the example adaptive apertures of FIGS. 1 to 7, 29,and 30 may be used to trim a single spot, a set of spots, a treatmentlayer, or a treatment field. A treatment field includes the extent ofradiation that can be applied at a particular layer, and may extendbeyond the layer itself. An example spot may have a Gaussiandistribution, as shown in the graph of FIG. 31. That is, thedistribution of protons in the spot is Gaussian in that the center 1500of the spot has the highest concentration of protons and thatconcentration decreases as the distance from the center of the spotdecreases. This Gaussian distribution can have an effect on treatmentplanning. For example, in some implementations, a TPP may take thisdistribution into account in determining the appropriate dose for agiven location of a radiation target, and also may take thisdistribution into account in determining whether, and where, to trim thespot using the adaptive aperture (or any other appropriate spot-trimmingmechanism). For example, referring to FIG. 2, the adaptive aperture maybe used to trim spots at the border between a radiation target definedby circle 708 (e.g., a tumor) and healthy tissue. However, trimming isnot limited to the border between diseased and healthy tissue. Forexample, a treatment plan may require that spots interior to a treatmentlayer be trimmed, e.g., in order to achieve a desired dose distribution.Accordingly, the adaptive aperture may be configured to implementinterior spot trimming as well.

An example TPP is executed by a TPS. An example TPP references a librarycontaining information defining characteristics of pre-trimmed spotsthat the process may use to achieve a target dose distribution. Forexample, the library may define a trimmed spot based on one or moreparameters. For example, referring to FIG. 32, a pre-trimmed spot 1600(shown in top view) may be defined in terms of its radius and angle ofrotation. In the example of FIG. 32, pre-trimmed spot 1600 is created bytrimming original spot 1601 at chords 1602 and 1603. In pre-trimmed spot1600, the radius is the line 1605 from the center 1606 of thenon-trimmed spot that is perpendicular to the spot edge. In the exampleof FIG. 32, the angle of rotation is defined as the amount that the spothas been rotated 1607, either clockwise or counterclockwise, relative toits original position. In some examples, such as spot 1600 of FIG. 32multiple radii (in this case two) may define the spot. In someimplementations, a single radius may define the spot, in part. And, inother implementations, more than two radii may define a spot, in part.The library may store information defining characteristics of anyappropriate number of pre-trimmed spots, which may be used to generateactual spots.

A pre-trimmed spot may have any appropriate shape, and is not limited tothe shapes shown in FIG. 32. For example, a pre-trimmed spot may haveone or more step-like edges, like the spots trimmed in FIGS. 2 and 30.

In some implementations, additional, or other, information may be usedto define spots in the library. For example, area, shape, or otherdescriptive information may define each spot. This information may be inaddition to, or instead of, the radius and rotation indicated above Theinformation that defines each spot, e.g., a radius and rotation, isstored in computer memory, e.g., in one or more files, look-up tables,or other constructs, that enable the information to be indexed tocorresponding leaf movements of the adaptive aperture.

More specifically, in some implementations, each trimmed spot may becreated from a radiation spot (e.g., one generated by thesynchrocyclotron described herein) that has been trimmed. As describedherein, the trimming may be performed using the adaptive aperture. Theconfiguration of the adaptive aperture used to create each trimmed spotmay be indexed to, or otherwise stored in association with, theinformation in the library that defines the spot. The configuration mayinclude, but is not limited to, the leaf configuration of the adaptiveaperture (e.g., which leaves are extended and which are not), therotational angle of the adaptive aperture, the position(s) of theprimary and secondary carriage(s), and so forth. Any appropriateinformation that characterizes the configuration of the adaptiveaperture to produce the corresponding trimmed spot may be stored.

In some implementations, during treatment planning, the TPP performs aprocess, such as an optimization process, in which the TPP selectsinformation for pre-trimmed spots from the library in order to achievethe target dose distribution for the treatment. For example, the TPP mayuse that information to simulate dose distributions for trimmed spotsiteratively until the target dose distribution, or a dose distributionacceptably close to the target dose distribution, is achieved. Theinformation that produces the best dose distribution is received by acomputing system that controls the adaptive aperture, and thatinformation is translated into leaf and/or carriage positions. In someimplementations, the TPP may employ a Monte Carlo optimization processin order to achieve the desired dose distribution. Generally, a MonteCarlo optimization process includes defining a domain of possible inputs(e.g., information defining trimmed spots from the library), generatinginputs randomly from a probability distribution over the domain,performing a deterministic computation on the inputs, and aggregatingthe results. In some implementations, the TPP may employ a PencilBeam-based optimization process, or any other appropriate optimizationprocess in order to achieve the desired dose distribution.

In some implementations, during treatment planning, the TPP performs aprocess, such as an optimization process, in which the TPP optimizestrimming curves in order to achieve a target dose distribution for thetreatment. For example, the TPP may obtain information defining trimmingcurves to be produced using the adaptive aperture, and use thatinformation to simulate dose distributions for trimmed spots iterativelyuntil the target dose distribution, or a dose distribution acceptablyclose to the target dose distribution, is achieved. The informationdefining the trimming curves may include, e.g., lengths, curvatures,angles, orientations, and any other appropriate information that candefine a trimming curve. In this example, the information is independentof the pre-trimmed spots in the library, and the pre-trimmed spots arenot used to control the adaptive aperture. Rather, the information thatproduces the best dose distribution is received by a computing systemthat controls the adaptive aperture, and that information is translatedinto leaf and/or carriage positions. As above, in some implementations,the TPP may employ a Monte Carlo optimization process, a PencilBeam-based optimization process, or any other appropriate optimizationprocess in order to achieve the desired dose distribution.

In some implementations, during treatment planning, the TPP performs aprocess, such as an optimization process, in which the TPP definesdifferent spot sizes and/or shapes to be produced through trimming basedon information such as, but not limited to, spot radius and orientation.For example, the TPP may use that information to simulate dosedistributions for trimmed spots iteratively until the target dosedistribution, or a dose distribution acceptably close to the target dosedistribution, is achieved. Information identifying the sizes and shapesmay include information identifying a spot radius and/or orientation asdescribed herein, or any other appropriate identifying information. Inthis example, the information is independent of the pre-trimmed spots inthe library, and the pre-trimmed spots are not used to control theadaptive aperture. Rather, the information that produces the best dosedistribution is received by a computing system that controls theadaptive aperture, and that information is translated into leaf and/orcarriage positions. As above, in some implementations, the TPP mayemploy a Monte Carlo optimization process, a Pencil Beam-basedoptimization process, or any other appropriate optimization process inorder to achieve the desired dose distribution.

In some implementations, during treatment planning, the TPP performs aprocess, such as an optimization process, in which the TPP defines leafand/or carriage movements of the adaptive aperture to perform treatment.That is, the TPP knows the geometry, structures, and capabilities of theadaptive aperture, and leverages this knowledge to optimize thetreatment plan. For example, the TPP may use that information tosimulate dose distributions for trimmed spots iteratively until thetarget dose distribution, or a dose distribution acceptably close to thetarget dose distribution, is achieved. The leaf and/or carriagepositions that are closest to the target dose distribution are provided,by the TPP, to a control/computing system that controls configuration ofthe adaptive aperture. In this example, the information identifying leafand/or carriage movements is independent of the pre-trimmed spots in thelibrary, and the pre-trimmed spots are not used to control the adaptiveaperture. Rather, the information is received by the control/computingsystem that controls the adaptive aperture, and that information is usedto position the leave(s) and/or carriage(s) of the adaptive aperture. Asabove, in some implementations, the TPP may employ a Monte Carlooptimization process, a Pencil Beam-based optimization process, or anyother appropriate optimization process in order to achieve the desireddose distribution.

In general, after the TPP determines the appropriate dose distribution,including information to control the adaptive aperture, the TPP providesthat information to a control system (e.g., one or more computers) forthe particle therapy (or other radiation therapy) system. In someimplementations, the information provided from the TPP identifies thespots in the library that are to be used to implement the dosedistribution, and indicates where those spots are to be formedon/applied to the irradiation target at the time of delivery of eachspot. In some implementations, the information provided from the TPPidentifies the spot sizes and shapes that are to be used to implementthe dose distribution, and indicates where those spots are to be formedon/applied to the irradiation target at the time of delivery of eachspot. Information identifying the sizes and shapes may includeinformation identifying a spot radius and/or orientation as describedherein, or any other appropriate identifying information. In someimplementations, the information provided from the TPP identifiestrimming curves to be produced by the adaptive aperture. In someimplementations, the information provided from the TPP includes leafand/or carriage positions that are specified for the adaptive aperture.

The control system uses the information received from the TPP todetermine the configuration of the adaptive aperture needed to obtainthe target dose distribution or a dose distribution that is acceptablyclose to the target dose distribution. In an example, information thatcharacterizes the configuration of the adaptive aperture needed tocreate a trimmed spot may be associated with (e.g., indexed to)information defining the corresponding pre-trimmed spot (e.g., itsradius and orientation). The control system obtains the informationcharacterizing the configuration of the adaptive aperture, and uses thatinformation, together with the information indicating where the spotsare to be applied at the time of delivery of each spot, to controloperation of the particle accelerator and the adaptive aperture. Thatis, the information indicating where the spots are to be applied at thetime of delivery of each spot is used to control beam output anddirection; and the information characterizing the configuration of theadaptive aperture is used to configure the adaptive aperture atappropriate times in order to achieve the target dose distribution. Inan example, information that characterizes the configuration of theadaptive aperture needed to create a trimming curve may be derived froma shape of that curve received from the TPP. In an example, informationthat characterizes the configuration of the adaptive aperture may bereceived directly from the TPP in the form of leaf and/or carriagepositions.

In operation, for each trimmed spot, the adaptive aperture is configuredto achieve the appropriate spot size and shape. For example, the leavesof the adaptive aperture are extended or retracted, as appropriate, toproduce a trimmed spot that is identical to, or approximates, a spot fora particular location. In some implementations, locations of theadaptive aperture leaves, and therefore movements thereof, aredetermined relative to a predefined isocenter of the irradiation target.Movements of the leaves are commanded by the control system inaccordance with the required configuration for each spot. Movements ofthe primary and/or secondary carriages may also be commanded, asappropriate, in addition to, or instead of, movements of the leaves. Asexplained, in some implementations, the size and shape of each spot mayvary spot-by-spot (e.g., on a spot-by-spot basis), requiringreconfiguration of the adaptive aperture in between spot scans. In someimplementations, the configuration of the adaptive aperture ismaintained between spot scans, thereby reducing the need forreconfiguration each time the beam is moved. In some implementations,e.g., at the interior of a layer of an irradiation target, trimming isnot performed, e.g., all of the leaves of the adaptive aperture may beretracted. In some implementations, including at the interior of a layerof the irradiation target, trimming is performed, e.g., to define one ormore spot edges to achieve the target dose distribution.

As described herein, treatment may be performed on the irradiationtarget layer-by-layer. Layers may be accessed by varying the energy ofthe particle beam, with higher-energy beams penetrating to reach deeperlayers (relative to the beam source). As described herein, the energy ofthe particle beam may be changed by moving one or more plates into theparticle beam path, by changing the energy of the beam using avariable-energy accelerator, or by a combination thereof.

In some implementations, the adaptive aperture may trim a single spot,part of a layer to be treated, the entire layer to be treated, or theentire radiation field for that layer. That is, the adaptive aperturemay be used to trim more than an individual spot or set of spots withina field or layer. For example, the adaptive aperture may be configureddifferently, for each layer or field for that layer. In this regard,FIG. 33 shows a side view of an irradiation target 1700 having severallayers to be treated, including layers 1701 and 1702. Referring also toFIGS. 1 to 7, the adaptive aperture may be configured to trim layer1702; and the adaptive aperture may be configured to trim the layer1701. In each case, appropriate leaves may be extended or retracted, andone or more carriages may be moved to appropriate locations, in order tochange the configuration of the adaptive aperture to a configurationthat is appropriate for the layer. The TPP may perform appropriateoptimizations to define the trimming to be performed for each layer.

In some implementations, the adaptive aperture may trim a curve that hasbeen generated by the TPP for all layers of an irradiation target. Morespecifically, in some implementations, an optimized treatment plan maynot require different trimming for different layers (e.g., depths) of anirradiation target. That is, a single trimming curve (an aperture may bea trimming curve) may be configured and used for all layers of theirradiation target, even if those layers have different cross-sectionalshapes. For example, in FIG. 34, layers 1801 and 1802 have differentwidths. The TPP may generate an optimized trimming curve that is capableof trimming both layers. For example, as shown in FIG. 34, a trimmingcurve 1804 may trim at edges of wider layers (e.g., 1802) of theirradiation target, and only trim the tail edge 1807 of a Gaussian spot1806 (depicted as an inverted Gaussian curve) produced at more narrowlayers (e.g., 1801). The TPP may generate the optimized trimming curveby dividing the irradiation target into voxels of a predefined shape andvolume, and by iteratively adjusting parameters for the voxels until anoptimized trimming curve is determined. For example, for each voxel, theTPP selects parameters such as spot weight, location, size, shape, etc.,and iterates through those parameters until the target dose distributionis obtained across the irradiation target, or until a dose distributionwithin a specified tolerance of the target dose distribution is obtainedacross the irradiation target. After that optimized dose distribution isdetermined, the TPP may determine a trimming curve that best fits eachlayer of the irradiation target based on the determined dosedistribution.

More specifically, in an example, the TPP examines the determined dosedistribution for each layer and, based on those dose distributions,selects a single trimming curve that is most appropriate for all layers.For example, in some implementations, the trimming curve may beconfigured to accommodate the irregular patterns of different layers ofthe irradiation target. Selection of the size and shape of the trimmingcurve may also be based on structures inside the irradiation target orexternal to the irradiation target. For example, different exteriorstructures may be more tolerant of exposure to radiation than others.The trimming curve may be configured to accommodate such tolerances.

As described, in some implementations, the TPP provides, to the controlsystem, specifications of the trimming curve of FIG. 34. Thespecifications may include, e.g., the shape and location of the trimmingcurve relative to a known point, such as an isocenter in the irradiationtarget. In an example, the control system configures the adaptiveaperture to produce a trimming curve that meets the specificationsprovided by the TPP. In this example, the adaptive aperture is notreconfigured to treat successive layers, and thus mimics a preconfigured(and not adaptive/reconfigurable) aperture or other appropriatestructure.

In the foregoing example, the same trimming curve is used for each layerto be treated. This can be advantageous since it allows the adaptiveaperture to be used with legacy TPPs. More specifically, some legacyTPPs are configured for operation with a predefined aperture, where aconventional aperture is a static (e.g., non-adaptive) structure orstructures that create a hole through which radiation passes unimpeded.By configuring the adaptive aperture so that it maintains the sameconfiguration throughout treatment, the adaptive aperture can be usedwith legacy TPPs of the type described above.

In the example implementations described above, the TPP selectsparameters such as spot weight, location, size, shape, etc., anditerates through those parameters until the target dose distribution isobtained across the irradiation target. In some example implementations,the TPP does not have knowledge of, or take into account, theconfiguration of the adaptive aperture when obtaining the target dosedistribution. Rather, the specifications provided by the TPP areinterpreted by the control system to control the configuration of theadaptive aperture, e.g., to extend or retract leaves, move carriage(s),etc. in order to achieve an appropriate trimming curve based on the dosedistribution.

As described, in some implementations, the TPP has knowledge of, andtakes into account, the configuration of the adaptive aperture whenobtaining a target dose distribution. For example, the TPP may know thenumber of leaves in the adaptive aperture, the dimensions and shape ofeach leaf, the relative locations of the leaves, the number ofcarriages, how the carriages move, and so forth. This information may betaken into account, along with, e.g., the spot weight, spot location,spot size, spot orientation, and/or spot shape, when determining anoptimized dose distribution for the irradiation target. The TPP may usethis information in determining appropriate leaf positions correspondingto each delivered spot. That is, the TPP has knowledge of the truegeometry and motion constraints of the adaptive aperture leaves andincludes that geometry directly in its optimization calculations. TheTPP then produces a prescription for the exact positions of the leavesand/or carriages for every spot. Thus, in this example, thespecifications provided by the TPP to the control system includeinformation used to configure the adaptive aperture. For example, thespecifications may include a configuration of leaves and/or carriages ofthe adaptive aperture. In some implementations, a different set ofconfigurations of the adaptive aperture, as appropriate, may be providedfor each layer of, or spot on, the irradiation target. In this example,information about the trimming curve itself need not be provided by theTPP, since the configuration information for the adaptive aperture(including, e.g., the leaf configuration information) provided by theTPP defines the trimming to be produced.

In an example implementation, the TPP performs an optimization process,such as the Monte Carlo optimization or the Pencil Beam optimization,using information defining different spot shapes (e.g., obtained fromthe library or elsewhere) and using known adaptive aperture (e.g., leaf)configurations. In an example optimization process, for a known particlebeam, the TPP may iterate through different combinations of beam shapeand adaptive aperture configurations to obtain a resulting dosage, andcompare the resulting dosage to a target dosage (for the area underconsideration). If the resulting dosage deviates from the target dosageby more than a defined amount, a different combination of spot shape andadaptive aperture configuration is selected, and the process is repeateduntil an optimization is achieved (e.g., the resulting dosage matchesthe target dosage for the area or is within the defined tolerancerelative to the target dosage).

In some implementations, a TPP selects beam spot shapes based on thedose and dose restrictions of an inverse planning process. In someimplementations, the selection of spot shapes and sizes may be based onspots defined in the library described herein that contains informationdefining characteristics of pre-trimmed spots. In some implementations,the selection of spot shapes and sizes may be independent of spotsdefined in the library described herein that contains informationdefining characteristics of pre-trimmed spots. For example, TPP mayconfigure the adaptive aperture—including leaves and/or carriages—toproduce spots having any appropriate shapes. In other words, the TPP maybe programmed with the capabilities of the particle therapy system, andalso be programmed with a treatment plan for an irradiation target, suchas a tumor. Given this information, the TPP may instruct the adaptiveaperture to produce spot shapes and sizes by trimming the particle beamin any appropriate manner to achieve the desired treatment. The trimmingthat is produced by the adaptive aperture is not limited to producingpredefined spots from the library in this example.

In some implementations, a TPP selects beam spot shapes based on thedose and dose restrictions of an inverse planning process. A radiationplan that describes the positioning and shape of multiple treatmentspots may be developed with reference to a dose map prepared by aphysician using planning software to convert the dose map to a radiationplan. The dose map may be prepared, for example, using a graphicsterminal with the physician viewing one or more CT images of the patientto define target (e.g., desired) doses in different zones within thevolume of the patient. An optimization process may be performed todetermine which spots to apply to the treatment area to achieve thetarget dose.

FIG. 37 shows an example of an optimization process 2100 that may beperformed, e.g., by the TPP. The process may be implemented as acomputer program stored on one or more non-transitory machine-readablemedia. The instructions may be executed on one or more processingdevices (e.g., microprocessors) to implement the operations shown inFIG. 37. In this regard, although the process of FIG. 37 is defined interms of physical entities, such as spots, intensities, treatment areas,and so forth, the process of FIG. 37 is not performed on those physicalentities, but rather is performed using data that represents thosephysical entities and that models those physical entities and theirinteractions. Accordingly, although the description of FIG. 37 and theaccompanying figures refers to the entities themselves (e.g., spots,treatment areas, etc.), the entity names are actually shorthand for datadescribing those entities (as the modeling and optimization process areperformed on a computer, and output a treatment plan that is laterimplemented using a therapy system, such as those described herein).

The optimization process includes optimizing (2101) a coarse beam set.Referring to FIG. 38, in this example, this operation (2101) includesobtaining a minimum objective dosage 2202 and a maximum objective dosage2201. In an example, the minimum objective is the minimum dosage to beapplied to a treatment area 2204, such as a tumor (e.g., 98% of adesired dose over 98% of the treatment area). The maximum objective isthe maximum amount of dosage to be applied outside the treatment area,e.g., to normal tissue or critical structures, such as organs. In someimplementations, the dosage may be for a single scan (e.g., part of atarget cumulative dose) and in some implementations the dosage may bethe target cumulative dose.

The minimum dosage and maximum dosage may be determined, e.g., by aphysician in the manner described above based on various factors. Datadefining a set of Gaussian spots (in this example, spots A, B, C, D, andE of FIG. 39) is used to model the effect of radiation in those spots onthe treatment area. Spots A, B, C, D, and E constitute an initialestimation of which spots will provide treatment to the treatment areagiven the constraints of the minimum objective and the maximumobjective, e.g., spots that come closest to achieving the minimumobjective but not exceeding the maximum objective. However, at thispoint, those objectives may not actually be met. At this stage—thecoarse beam set—the spots have the same, or about the same, intensity,as depicted graphically in FIG. 39. In some implementations, differentsets of coarse spots may be selected and the results of theirapplication modeled. The set that most closely approximates the targetdosage may be the set that is selected as the coarse set. For example, aset that is within a defined percentage of the target dose distributionmay be selected, with the target percentage being any appropriatepercentage, e.g., 5%, 10%, 15%, 20%, etc.

The optimization process includes performing (2102) spot intensityoptimization to further approximate the target dosage. In this example,spot intensity optimization includes identifying which spots should beincreased or decreased in intensity given constraints, such as theminimum objective and the maximum objective (based, e.g., on thelocation of the treatment area, the location of normal tissue, thelocation of critical structures, and other appropriate criteria).Referring to FIGS. 39 and 40, in this example, the optimization processrecognizes that spot E is at the edge of the treatment area 2204 andmostly outside of the treatment area. Therefore, the optimizationprocess decreases the intensity of spot E (e.g., to some level at orbelow the maximum objective). This is depicted graphically in FIG. 40 byspot E being reduced in size and/or shape relative to spots A, B, C, andD. This optimization may be performed for multiple spots, asappropriate, and brings the modeled dosage closer to the target dosage.In some implementations, different beam intensities may be selected andthe results of their application modeled. The beam intensity that mostclosely approximates the target dosage at the appropriate location maybe the beam intensity that is selected.

The optimization process includes identifying (2103) spots within (e.g.,that affect) one or more transition regions in the treatment area. Forexample a transition region may be the edge 2205 of the treatment area,and a spot at the transition region may include spot D (as evidenced byline 2206). Notably, a transition region need not only be at an edge ofthe treatment area. As described herein, transition regions may be atlocations internal to the treatment area, and may depend upon the doseprofile, the locations of critical structures in the treatment area, theshape of a tumor to be treated, and other appropriate factors.

The optimization process includes replacing (2104) a spot (or spots) atthe transition region(s) with one or more spots of alternate shapes. Insome implementations, referring to FIG. 41, this operation includesreplacing spot D at the transition regions with a pre-trimmed spot fromthe library that best approximates the target dose distribution. Forexample, FIG. 42 shows side views of examples of pre-trimmed spots inthe library (with the side views showing distributions of protons withinthe spot, e.g., Gaussian or trimmed from Gaussian). An appropriate spot,such as spot 2401, is selected and replaced for spot D, with resultingreplaced spot D′ having (in this case) the shape shown in FIG. 41. Insome implementations, differently-shaped spots may be selected from thelibrary and the results of their application modeled. The pre-trimmedspot that most closely approximates the target dosage at the appropriatelocation may be selected for use. Operations 2101 through 2104 may berepeated, as necessary and appropriate, for different treatment areasand different locations within a single treatment area.

In some implementations, operation 2104 does not include use ofpre-trimmed spots from the library. Instead, operation 2104 may includedefining spot shapes based on information including, but not limited to,the desired treatment that is to be applied to an irradiation target andthe ways in which the leaves and carriages of the adaptive aperture canmove to produce one or more trimming curves. The configuration of one ormore of the spots may be defined in real-time and, in someimplementations, are not predefined. The spots may be defined usingradius and/or orientation information for each spot, alone or incombination with any other appropriate information that can be used tospecify spot size and shape. In this regard, in some implementations,real-time may include actions that occur on a continuous basis or trackeach other in time, taking into account delays associated withprocessing, data transmission, hardware, and the like.

The optimization process outputs (2105) information that defines whichspots to apply to the treatment area. Some of the spots may not betrimmed (e.g., spots A, B, C), in which case only intensity and otherappropriate information is provided to the therapy control system. Fortrimmed spots (e.g., spot D), those match the spots from the library,and information identifying those pre-trimmed spots is output to thecontrol system. For implementations that do not employ pre-trimmedspots, information characterizing spot size and shape may be used. Asdescribed herein, information in the library defining the shape of thosespots is indexed or otherwise associated with configurations of theadaptive aperture. Accordingly, that information is obtained by thecontrol system, and used to control the adaptive aperture, asappropriate, to form those spots. For intensity-modulated spots,information for those spots is also output and used to produce spotswith appropriate intensity. In some implementations, intensity-modulatesspots may also be pre-trimmed spots that have been modulated inaccordance with a desired intensity.

As noted above, a trimming curve may define an aperture, e.g., one ormore curves or a hole that limit the extent to which radiation passes toan irradiation target. In some implementations, a trimming curve maysimply be a line or curve that defines an edge of a spot or field of anirradiation target. For example referring to FIG. 35, a layer 1901 mayinclude multiple internal trimming curves 1902 to 1905, none of whichare closed curves.

FIG. 36 shows how configuration of the adaptive aperture fits into theprocess of FIG. 17. Other than operations 2001 and 2002, the operationsof FIG. 36 are the same as those of FIG. 17. In this example, as part ofthe layer selection process or prior thereto, the control system of aparticle therapy system receives (2001), from a TPP, information that isbased on a dose distribution for an irradiation target; and configures(2002) the adaptive aperture by performing at least one of the followingoperations: (A) moving structures to trim spots of a particle beam sothat the spots of the particle beam approximate pre-trimmed spots forwhich characteristics are obtained based on the information received;(B) moving structures to produce a trimming curve for each layer of anirradiation target based on specifications of trimming curves fordifferent layers included in the information received; (C) movingstructures to produce a single trimming curve for all radiation fieldsof an irradiation target based on specifications of the single trimmingcurve included in the information received; or (D) moving structures toproduce a trimming curve for a radiation field of an irradiation targetbased on configuration information for the structures in the informationreceived.

As described herein, in some implementations, the structures may beleaves that are moved into, or out of, the beam path. In someimplementations, process 2000 of FIG. 36 may be implemented with adevice other than the adaptive aperture. As appropriate, any two or moreof the foregoing operations (A), (B), (C), or (D) may be combined, orused together, in whole or in part.

Also described herein is an example of a particle accelerator system,such as a proton or ion therapy system, which may employ adaptiveapertures of FIGS. 1 to 7, 29, and 30, and which may configure thoseadaptive apertures in accordance with information from a TPP asdescribed herein. The example particle therapy system includes aparticle accelerator—in this example, a synchrocyclotron—mounted on agantry. The gantry enables the accelerator to be rotated around apatient position, as explained in more detail below, to allow a particlebeam from the particle accelerator hit any arbitrary treatment area inthe patient. In some implementations, the gantry is steel and has twolegs mounted for rotation on two respective bearings that lie onopposite sides of a patient. The particle accelerator is supported by asteel truss that is long enough to span a treatment area in which thepatient lies and that is attached at both ends to the rotating legs ofthe gantry. As a result of rotation of the gantry around the patient,the particle accelerator also rotates.

In an example implementation, the particle accelerator (e.g., thesynchrocyclotron) includes a cryostat that holds one or moresuperconducting coils, each for conducting a current that generates amagnetic field (B). In an example, the cryostat uses liquid helium (He)to maintain each coil at superconducting temperatures, e.g., 4° Kelvin(K). Magnetic yokes or smaller magnetic pole pieces are located insidethe cryostat, and define the shape of a cavity in which particles areaccelerated. Magnetic shims may pass through the magnetic yokes or polepieces to change the shape and/or magnitude of the magnetic field in thecavity.

In this example implementation, the particle accelerator includes aparticle source (e.g., a Penning Ion Gauge—PIG source) to provide anionized plasma column to the cavity. Hydrogen gas is ionized to producethe plasma column. A voltage source provides a radio frequency (RF)voltage to the cavity to accelerate pulses of particles from the plasmacolumn into the cavity. The magnetic field in the cavity is shaped tocause particles to move orbitally within the cavity. The magnetic fieldmay be, e.g., at least 4 Tesla, as explained herein.

As noted, in an example, the particle accelerator is a synchrocyclotron.Accordingly, the RF voltage is swept across a range of frequencies toaccount for relativistic effects on the particles (e.g., increasingparticle mass) when accelerating particles from the plasma column. Themagnetic field produced by running current through a superconductingcoil, together with the shape of the cavity, causes particlesaccelerated from the plasma column to accelerate orbitally within thecavity. In other implementations, a particle accelerator other than asynchrocyclotron may be used. For example, a cyclotron, a synchrotron, alinear accelerator, and so forth may be substituted for thesynchrocyclotron described herein.

In the example synchrocyclotron, a magnetic field regenerator(“regenerator”) is positioned near the outside of the cavity (e.g., atan interior edge thereof) to adjust the existing magnetic field insidethe cavity to thereby change locations (e.g., the pitch and angle) ofsuccessive orbits of the particles accelerated from the plasma column sothat, eventually, the particles output to an extraction channel thatpasses through the cryostat. The regenerator may increase the magneticfield at a point in the cavity (e.g., it may produce a magnetic field“bump” of about 2 Tesla or so at an area of the cavity), thereby causingeach successive orbit of particles at that point to precess outwardlytoward the entry point of the extraction channel until it reaches theextraction channel. The extraction channel receives, from the cavity,particles accelerated from the plasma column and outputs the receivedparticles from the cavity as a particle beam.

The superconducting (“main”) coils can produce relatively high magneticfields. The maximum magnetic field generated by a main coil may bewithin a range of 4 T to 20 T or more. For example, a main coil may beused to generate magnetic fields at, or that exceed, one or more of thefollowing magnitudes: 4.0 T, 4.1 T, 4.2 T, 4.3 T, 4.4 T, 4.5 T, 4.6 T,4.7 T, 4.8 T, 4.9 T, 5.0 T, 5.1 T, 5.2 T, 5.3 T, 5.4 T, 5.5 T, 5.6 T,5.7 T, 5.8 T, 5.9 T, 6.0 T, 6.1 T, 6.2 T, 6.3 T, 6.4 T, 6.5 T, 6.6 T,6.7 T, 6.8 T, 6.9 T, 7.0 T, 7.1 T, 7.2 T, 7.3 T, 7.4 T, 7.5 T, 7.6 T,7.7 T, 7.8 T, 7.9 T, 8.0 T, 8.1 T, 8.2 T, 8.3 T, 8.4 T, 8.5 T, 8.6 T,8.7 T, 8.8 T, 8.9 T, 9.0 T, 9.1 T, 9.2 T, 9.3 T, 9.4 T, 9.5 T, 9.6 T,9.7 T, 9.8 T, 9.9 T, 10.0 T, 10.1 T, 10.2 T, 10.3 T, 10.4 T, 10.5 T,10.6 T, 10.7 T, 10.8 T, 10.9 T, 11.0 T, 11.1 T, 11.2 T, 11.3 T, 11.4 T,11.5 T, 11.6 T, 11.7 T, 11.8 T, 11.9 T, 12.0 T, 12.1 T, 12.2 T, 12.3 T,12.4 T, 12.5 T, 12.6 T, 12.7 T, 12.8 T, 12.9 T, 13.0 T, 13.1 T, 13.2 T,13.3 T, 13.4 T, 13.5 T, 13.6 T, 13.7 T, 13.8 T, 13.9 T, 14.0 T, 14.1 T,14.2 T, 14.3 T, 14.4 T, 14.5 T, 14.6 T, 14.7 T, 14.8 T, 14.9 T, 15.0 T,15.1 T, 15.2 T, 15.3 T, 15.4 T, 15.5 T, 15.6 T, 15.7 T, 15.8 T, 15.9 T,16.0 T, 16.1 T, 16.2 T, 16.3 T, 16.4 T, 16.5 T, 16.6 T, 16.7 T, 16.8 T,16.9 T, 17.0 T, 17.1 T, 17.2 T, 17.3 T, 17.4 T, 17.5 T, 17.6 T, 17.7 T,17.8 T, 17.9 T, 18.0 T, 18.1 T, 18.2 T, 18.3 T, 18.4 T, 18.5 T, 18.6 T,18.7 T, 18.8 T, 18.9 T, 19.0 T, 19.1 T, 19.2 T, 19.3 T, 19.4 T, 19.5 T,19.6 T, 19.7 T, 19.8 T, 19.9 T, 20.0 T, 20.1 T, 20.2 T, 20.3 T, 20.4 T,20.5 T, 20.6 T, 20.7 T, 20.8 T, 20.9 T, or more. Furthermore, a maincoil may be used to generate magnetic fields that are within the rangeof 4 T to 20 T (or more, or less) that are not specifically listedabove.

In some implementations, such as the implementation shown in FIGS. 8 and9, large ferromagnetic magnetic yokes act as a return for stray magneticfield produced by the superconducting coils. For example, in someimplementations, the superconducting magnet can generate a relativelyhigh magnetic field of, e.g., 4 T or more, resulting in considerablestray magnetic fields. In some systems, such as that shown in FIGS. 8and 9, the relatively large ferromagnetic return yoke 100 is used as areturn for the magnetic field generated by superconducting coils. Amagnetic shield surrounds the yoke. The return yoke and the shieldtogether dissipated stray magnetic field, thereby reducing thepossibility that stray magnetic fields will adversely affect theoperation of the accelerator.

In some implementations, the return yoke and shield may be replaced by,or augmented by, an active return system. An example active returnsystem includes one or more active return coils that conduct current ina direction opposite to current through the main superconducting coils.In some example implementations, there is an active return coil for eachsuperconducting coil, e.g., two active return coils—one for eachsuperconducting coil (referred to as a “main” coil). Each active returncoil may also be a superconducting coil that surrounds the outside of acorresponding main superconducting coil concentrically.

Current passes through the active return coils in a direction that isopposite to the direction of current passing through the main coils. Thecurrent passing through the active return coils thus generates amagnetic field that is opposite in polarity to the magnetic fieldgenerated by the main coils. As a result, the magnetic field generatedby an active return coil is able to dissipate at least some of therelatively strong stray magnetic field resulting from the correspondingmain coil. In some implementations, each active return may be used togenerate a magnetic field of between 2.5 T and 12 T or more. Forexample, the magnetic field may be 2.5 T, 2.6 T, 2.7 T, 2.8 T, 2.9 T,3.0 T, 3.1 T, 3.2 T, 3.3 T, 3.4 T, 3.5 T, 3.6 T, 3.7 T, 3.8 T, 3.9 T,4.0 T, 4.1 T, 4.2 T, 4.3 T, 4.4 T, 4.5 T, 4.6 T, 4.7 T, 4.8 T, 4.9 T,5.0 T, 5.1 T, 5.2 T, 5.3 T, 5.4 T, 5.5 T, 5.6 T, 5.7 T, 5.8 T, 5.9 T,6.0 T, 6.1 T, 6.2 T, 6.3 T, 6.4 T, 6.5 T, 6.6 T, 6.7 T, 6.8 T, 6.9 T,7.0 T, 7.1 T, 7.2 T, 7.3 T, 7.4 T, 7.5 T, 7.6 T, 7.7 T, 7.8 T, 7.9 T,8.0 T, 8.1 T, 8.2 T, 8.3 T, 8.4 T, 8.5 T, 8.6 T, 8.7 T, 8.8 T, 8.9 T,9.0 T, 9.1 T, 9.2 T, 9.3 T, 9.4 T, 9.5 T, 9.6 T, 9.7 T, 9.8 T, 9.9 T,10.0 T, 10.1 T, 10.2 T, 10.3 T, 10.4 T, 10.5 T, 10.6 T, 10.7 T, 10.8 T,10.9 T, 11.0 T, 11.1 T, 11.2 T, 11.3 T, 11.4 T, 11.5 T, 11.6 T, 11.7 T,11.8 T, 11.9 T, 12.0 T, or more. Furthermore, an active return coil maybe used to generate magnetic fields that are within the range of 2.5 Tto 12 T (or more, or less) that are not specifically listed above.

Referring to FIG. 10, at the output of extraction channel 102 ofparticle accelerator 105 (which may have the configuration shown inFIGS. 8 and 9), is an example scanning system 106 that may be used toscan the particle beam across at least part of an irradiation target.FIG. 11 also shows examples of components of the scanning system. Theseinclude, but are not limited to, a scanning magnet 108, an ion chamber109, and an energy degrader 110. Other components that may beincorporated into the scanning system are not shown in FIG. 11,including, e.g., one or more scatterers for changing beam spot size. Theexample scanning system, including components thereof, may be mounted tothe gantry and move along with the particle accelerator during movementof the gantry.

In an example operation, scanning magnet 108 is controllable in twodimensions (e.g., Cartesian XY dimensions) to direct the particle beamacross a treatment area (e.g., a cross-section) of an irradiationtarget. Ion chamber 109 detects the dosage of the beam and feeds-backthat information to a control system to adjust beam movement. Energydegrader 110 is controllable to move material (e.g., one or moreindividual plates) into, and out of, the path of the particle beam tochange the energy of the particle beam and therefore the depth to whichthe particle beam will penetrate the irradiation target. In this way,the energy degrader selects a depth-wise layer of an irradiation targetto scan in two dimensions.

FIGS. 12 and 13 show views of an example scanning magnet 108. In thisexample implementation, scanning magnet 108 includes two coils 111,which control particle beam movement in the X-dimension, and two coils112, which control particle beam movement in the Y-dimension. Control isachieved, in some implementations, by varying current through one orboth sets of coils to thereby vary the magnetic field(s) producedthereby. By varying the magnetic field(s) appropriately, the particlebeam can be moved in the X- and/or Y-dimension across the irradiationtarget. In some implementations, the scanning magnet is not movablephysically relative to the particle accelerator. In otherimplementations, the scanning magnet may be movable relative to theparticle accelerator (e.g., in addition to the movement provided by thegantry). In some implementations, the scanning magnet may becontrollable to move the particle beam continuously so that there isuninterrupted motion of the particle beam over at least part of, andpossibly all of, a layer of an irradiation target being scanned or aportion thereof (e.g., a treatment area). In other implementations, thescanning magnets are controllable at intervals or specific times. Insome implementations, there may be different scanning magnets to controlall or part movement of a particle beam in the X- and/or Y-dimensions.

In some implementations, scanning magnet 108 may have an air core. Inother implementations, scanning magnet 108 may have a ferromagnetic(e.g., an iron) core. In general, a magnet having an air core includes amagnetic coil around a core that is a non-ferromagnetic material, suchas air. For example, an air core magnet may include self-supportingcoils that surround air. In some implementations, an air core magnet mayinclude coils that are wound around an insulator, such as ceramic orplastic, which may or may not include air.

In some cases, an air core may have advantages over a ferromagneticcore. For example, the amount that the particle beam moves (e.g., isdeflected) in the X- and/or Y-dimensions is determined, at least inpart, based on the amount of current applied to the magnet (referred toas the “magnet current”). A scanning magnet typically has a movement (ordeflection) range, which is the extent over which the magnet will movethe beam. At extremes of this range, such as at the edges, largeramounts of current are applied to the scanning magnet in order toachieve relatively high amounts of beam deflection. Some types ofscanning magnets having a ferromagnetic core may saturate at theseextremes, resulting in a non-linear relationship between current andmagnet movement. That is, the amount of deflection produced by themagnet may not be linearly proportional to the amount of current appliedto the magnet. Due to this non-linearity, in some cases, it may bedifficult to determine and/or set some beam locations using magnetcurrent. Accordingly, when a scanning magnet having a ferromagnetic coreis used, there may need to be some calibration and/or compensationperformed in order to correct for non-linearities such as that describedabove.

In contrast, a scanning magnet having an air core may not saturate inthe same manner as a scanning magnet having a ferromagnetic core. Forexample, an air core magnet may not saturate or may saturate less than amagnet having a ferromagnetic core. As a result, the relationshipbetween current and magnet movement may be more linear, particularly atthe range extremes, making determinations of beam location based onmagnet current more accurate, at least in some cases. This increasedlinearity also can enable more accurate movement of the beam,particularly at range extremes. That is, since the relationship betweencurrent and beam movement is generally more linear over a larger rangewhen an air core scanning magnet is used, beam movement may be moreeasily reproducible using an air core scanning magnet. This can beadvantageous, since a depth-wise layer of an irradiation target mayrequire multiple scans, each providing a percentage of a totalcumulative radiation dose. Precision in delivery of multiple doses tothe same area, such as that which can be obtained through use of an aircore scanning magnet, can affect the efficacy of the treatment.

Although the relationship between current and magnet movement may bemore linear in an air core magnet, in some cases, an air core magnet maybe more susceptible to stray magnetic fields than a magnet having aferromagnetic core. These stray magnetic fields may impact the scanningmagnet during motion of the scanning magnet produced by the gantry.Accordingly, in some implementations that use a scanning magnet havingan air core, the current applied to the scanning magnet to move the beammay be calibrated to account for the position of the scanning magnetrelative to the patient (or, correspondingly, to account for theposition of the gantry, since the position of the gantry corresponds tothe position of the scanning magnet relative to the patient). Forexample, the behavior of the scanning magnet may be determined and, ifnecessary, corrected, for different rotational positions (angles) of thegantry, e.g., by increasing or decreasing some applied current based onrotational position.

In some implementations, the scanning magnet may have a core that iscomprised of both air and a ferromagnetic material (e.g., iron). In suchimplementations, the amount and configuration of air and ferromagneticmaterial in the core may be determined taking the foregoing factors intoaccount.

In some implementations, a current sensor 118 may be connected to, or beotherwise associated with, scanning magnet 108. For example, the currentsensor may be in communication with, but not connected to, the scanningmagnet. In some implementations, the current sensor samples currentapplied to the magnet, which may include current to coil(s) forcontrolling beam scanning in the X-dimension and/or current to coil(s)for controlling beam scanning in the Y-dimension. The current sensor maysample current through the magnet at times that correspond to theoccurrence of pulses in the particle beam or at a rate that exceeds therate that the pulses occur in the particle beam. In the latter case, thesamples, which identify the magnet current, are correlated to detectionof the pulses by the ion chamber described below. For example, the timesat which pulses are detected using the ion chamber (described below) maybe correlated in time to samples from the current sensor, therebyidentifying the current in the magnet coil(s) at the times of thepulses. Using the magnet current, it thus may be possible to determinethe location on the irradiation target (e.g., on a depth-wise layer ofthe irradiation target) where each pulse, and thus dose of particles,was delivered. The location of the depth-wise layer may be determinedbased on the position of the energy degrader (e.g., the number ofplates) in the beam path.

During operation, the magnitude(s) (e.g., value(s)) of the magnetcurrent(s) may be stored for each location at which a dose is delivered,along with the amount (e.g., intensity) of the dose. A computer system,which may be either on the accelerator or remote from the acceleratorand which may include memory and one or more processing devices, maycorrelate the magnet current to coordinates within the irradiationtarget, and those coordinates may be stored along with the amount of thedose. For example, the location may be identified by depth-wise layernumber and Cartesian XY coordinates or by Cartesian XYZ coordinates(with the layer corresponding to the Z coordinate). In someimplementations, both the magnitude of the magnet current and thecoordinate locations may be stored along with the dose at each location.This information may be stored in memory either on, or remote from, theaccelerator. As described in more detail herein, this information may beused during scanning to apply multiple doses to the same locations toachieve target cumulative doses.

In some implementations, ion chamber 109 detects dosage (e.g., one ormore individual doses) applied by the particle beam to positions on anirradiation target by detecting the numbers of ion pairs created withina gas caused by incident radiation. The numbers of ion pairs correspondto the dose provided by the particle beam. That information is fed-backto the computer system and stored in memory along with the time that thedose is provided. This information may be correlated to, and stored inassociation with, the location at which the dose was provided and/or themagnitude of the magnet current at that time, as described above.

As described in more detail below, in some implementations, the scanningsystem is run open loop, in which case the particle beam is moved freelyand uninterrupted across an irradiation target so as to substantiallycover the target with radiation. As the radiation is delivered,dosimetry implemented by the particle therapy control system records(e.g., stores) the amount of the radiation per location and informationcorresponding to the location at which the radiation was delivered. Thelocation at which the radiation was delivered may be recorded ascoordinates or as one or more magnet current values, and the amount ofthe radiation that was delivered may be recorded as dosage in grays.Because the system is run open loop, the delivery of the radiation isnot synchronized to the operation of the particle accelerator (e.g., toits RF cycle). However, the dosimetry may be synchronized to theoperation of the particle accelerator. More specifically, the dosimetryrecords the amount and location of each dose delivered as the dose isdelivered (that is, as close in time to delivery as possible given thelimits of technology). Since the dose is delivered in synchronism withthe operation of the accelerator (e.g., one pulse is delivered per RFcycle), in some implementations, the dosimetry that records the dose andthe location operates in synchronism, or substantially in synchronism,with delivery of radiation doses to the target, and thus in synchronismwith the operation of the particle accelerator, such as its RF cycle.

FIG. 14 shows a range modulator 115, which is an example implementationof energy degrader 110. In some implementations, such as that shown inFIG. 14, the range modulator includes a series of plates 116. The platesmay be made of one or more of the following example materials: carbon,beryllium or other material of low atomic number. Other materials,however, may be used in place of, or in addition to, these examplematerials.

One or more of the plates is movable into, or out of, the beam path tothereby affect the energy of the particle beam and, thus, the depth ofpenetration of the particle beam within the irradiation target. Forexample, the more plates that are moved into the path of the particlebeam, the more energy that will be absorbed by the plates, and the lessenergy the particle beam will have. Conversely, the fewer plates thatare moved into the path of the particle beam, the less energy that willbe absorbed by the plates, and the more energy the particle beam willhave. Higher energy particle beams typically penetrate deeper into theirradiation target than do lower energy particle beams. In this context,“higher” and “lower” are meant as relative terms, and do not have anyspecific numeric connotations.

Plates are moved physically into, and out of, the path of the particlebeam. For example, as shown in FIG. 15, a plate 116 a moves along thedirection of arrow 117 between positions in the path of the particlebeam and outside the path of the particle beam. The plates arecomputer-controlled. Generally, the number of plates that are moved intothe path of the particle beam corresponds to the depth at which scanningof an irradiation target is to take place. For example, the irradiationtarget can be divided into cross-sections or depth-wise layers, each ofwhich corresponds to an irradiation depth. One or more plates of therange modulator can be moved into, or out of, the beam path to theirradiation target in order to achieve the appropriate energy toirradiate each of these cross-sections or depth-wise layers of theirradiation target. The range modulator may be stationary relative tothe particle beam during scanning of a part of (e.g., cross-section of)an irradiation target, except for its plates moving in and out of thepath of the particle beam. Alternatively, the range modulator of FIGS.14 and 15 may be replaced with a range modulator that, at least some ofthe time, tracks movement of the particle beam, thereby enabling use ofsmaller plates.

In implementations that use a range modulator of the type describedabove, the number of plates that are moved into the beam pathdetermine/set the depth-wise layer of the irradiation target that is tobe scanned. For example, if two plates are moved into the beam path, thelayer will be more shallow than if one or no plates are moved into thebeam path. The layer may be identified, and stored in memory, based onthe number of plates moved into the beam path. In some implementations,the plates may have different heights. In such implementations, theheights of the various plates also affect which layer is to be scanned(e.g., how deep the particle beam will penetrate the target).

In some implementations, the particle accelerator may be avariable-energy particle accelerator. In example systems where avariable-energy particle accelerator is used, there may be less need foran energy degrader of the type described herein, as the energy level ofthe particle beam may be controlled by the particle accelerator. Forexample, in some systems that employ a variable-energy particleaccelerator, an energy degrader may not be needed. In some systems thatemploy a variable-energy particle accelerator, an energy degrader maystill be used to change beam energy levels.

In some implementations, a treatment plan is established prior totreating the irradiation target. The treatment plan may be stored inmemory that is accessible to a computer system that controls operationof the particle therapy system. As described, the treatment plan may bereceived from a TPS/TPP and may include information about how radiationtreatment is to be provided by the particle therapy system. For example,the treatment plan may specify how scanning is to be performed for aparticular irradiation target. In some implementations, the treatmentplan specifies that raster scanning is to be performed. Raster scanningincludes producing an uninterrupted movement of the particle beam acrossthe irradiation target. For example, the scanning magnet movescontinually to scan (e.g., move) the particle beam across theirradiation target so as to produce uninterrupted movement of theparticle beam over at least part of a layer of an irradiation target.The movement may be uninterrupted across an entire layer of theirradiation target or across only part of a layer. In someimplementations, the beam may be moved at a constant speed along all orpart of a layer of the irradiation target. In some implementations, thespeed at which the beam is moved along all or part of a layer of theirradiation target may vary. For example, the particle beam may movemore quickly across internal portions of a layer than at edges of thelayer. The speed of movement may be specified in the treatment plan.

In some implementations, the treatment plan may also specify the targetcumulative dose of radiation (particles) to be applied to variouspositions on layers of an irradiation target. The dose is cumulative inthe sense that it may be achieved through application of one or moredoses of particles. For example, the same location (e.g., in XYZ space)on an irradiation target may be irradiated ten times, each time with 10%of the target cumulative dose to achieve the target cumulative dose. Insome implementations, the treatment plan need not specify the amount ofdose for each location, the locations, or the number of times thatlocations are to be irradiated. That is, this information may be omittedfrom the treatment plan in some implementations. Rather, in someimplementations, the intensity of the particle beam may be setbeforehand to provide a particular dose of radiation per instance ofirradiation. The particle beam may then be scanned over a layer of theirradiation target in an open loop manner, without requiring feedback tomove to a next location. As the particle beam is scanned, the locationof the beam is determined and the corresponding dose at that location isdetermined. The determination may be made at about the same time as thescanning and delivery (that is, as close in time to delivery as possiblegiven the limits of technology). The cumulative dose at that location,which includes the current dose as well as any dose previously deliveredduring the current treatment, is compared to the target cumulative dosefrom the treatment plan. If the two do not match, then additional dosemay be applied to that location during a subsequent scan. Since it isnot always known precisely how much radiation will be delivered to alocation per scan, the number of times that a location is scanned maynot be set beforehand. Likewise, since there may be fluctuations in theamount of radiation actually delivered per scan to a location, theprecise amount of radiation per scan is not necessarily set beforehand.Consequently, in some implementations, such information need not beincluded in the treatment plan.

In some implementations, the treatment plan may also include one or morepatterns, over which the particle beam may be scanned per layer. Thetreatment plan may also specify the number of plates of an energydegrader to achieve a particular energy level/layer. Otherimplementations may include information in addition to, or instead of,that specified above.

In some implementations, the overall treatment plan of an irradiationtarget may include different treatment plans for differentcross-sections (layers) of the irradiation target. The treatment plansfor different cross-sections may contain the same information ordifferent information, such as that provided above.

The scanning system may include the adaptive aperture of FIGS. 1 to 7,29, and 30 (or a variant thereof), which is placeable relative to theirradiation target to limit the extent of the particle beam and therebylimit the extent of the particle beam. For example, the adaptiveaperture may be placed in the beam path down-beam of the energy degraderand before the particle beam hits the treatment area of the irradiationtarget. The adaptive aperture is controllable to allow at least part ofthe particle beam to pass therethrough and then hit certain parts of thetreatment area, while preventing the particle beam from hitting otherparts of the patient. For example, the adaptive aperture may becontrolled to prevent the particle beam from hitting healthy tissue orto prevent the particle beam from hitting other parts of the irradiationtarget (e.g., if certain parts of the target are to receive moreradiation than other parts). The adaptive aperture may be controlled toperform trimming internal to, or external to, a layer of an irradiationtarget, as described. FIG. 16 depicts placement of an implementation 770of the adaptive aperture described herein relative to a patient 771. Thedirection of beam 771 a is also shown.

As noted above, in some implementations, scanning is performed in anopen-loop manner, e.g., by an open-loop control system that may beimplemented using one or more processing devices, such as the computingdevice that controls the particle therapy system. In this example,open-loop scanning includes moving the particle beam across anirradiation target to substantially cover the target with radiation. Insome implementations, movement is not synchronized with operation of theaccelerator, e.g., with the RF frequency, but rather runs independentlyof the operation of the accelerator when the accelerator is operating.For example, movement of the particle beam may be uninterrupted, and notdependent upon the RF cycle of the particle accelerator. Uninterruptedmovement may occur across all or part of a layer of an irradiationtarget. However, as described herein, the dosimetry may be synchronizedwith delivery of pulses of the particle beam to the irradiation target.In examples where the dosimetry is synchronized with delivery of pulsesof the particle beam, the dosimetry is also synchronized with operationof the accelerator (e.g., with the RF frequency used to draw pulses ofthe particle beam from the ion source plasma column).

The radiation level of an individual dose of particle beam (e.g., anindividual pulse from the accelerator) may be set beforehand. Forexample, each individual dose may be specified in grays. An individualdose may be, or correspond to, a percentage of the target cumulativedose that is to be applied to a location (e.g., an XYZ coordinate) in anirradiation target. In some implementations, the individual dose may be100% of the target cumulative dose and, as a result, only a single scanmay be needed to deliver a single dose of radiation (e.g., one or moreparticle pulses) per location to the irradiation target. In someimplementations, the individual dose may be less than 100% of the targetcumulative dose, resulting in the need for multiple scans of the samelocation to deliver multiple doses of radiation to the irradiationtarget. The individual dose may be any appropriate percentage of thetarget cumulative dose, such as: 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%,10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 25%, 30%, 35%,40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or anypercentage in between these values.

The scanning magnet current may be controlled, in accordance with thetreatment plan, to scan a depth-wise layer of the irradiation target.The layer is selected by appropriately positioning one or more energydegraders from the range compensator in the path of the particle beamand/or by setting an energy level of a variable-energy particleaccelerator. As the layer is scanned, the current sensor samples thecurrent applied to the scanning magnet. The amount of magnet current maybe recorded, e.g., stored in memory. If more than one magnet or magnetcoil is used, the amount of magnet current may be stored along with theidentity of the magnet or coil. In addition, the current may becorrelated to coordinates within the irradiation target (e.g., CartesianXYZ coordinates) and those coordinates may be stored in addition to, orinstead of, the corresponding magnet current. As explained above, thecurrent sensor may sample the magnet current and correlate the samplingtime to the time at which an irradiation dose (e.g., pulse) isdelivered.

In this regard, ion chamber 109 may detect the intensity of dosesdelivered to the irradiation target as that dose is delivered. Theintensity of each dose is recorded (e.g., stored in memory) along withthe location of each delivered dose. As noted, the location of eachdelivered dose may be stored by coordinates, magnet current, or usingsome other appropriate metric. As noted above, the dosimetry—the doseverification—may be synchronized with delivery of the dose and, thus,with the output of the accelerator (which corresponds to the RFfrequency, as described above). Accordingly, in some implementations,each time a dose is delivered, the intensity of that dose is determinedalmost immediately and the location at which the dose is applied isdetermined almost immediately. This information may be stored in one ormore tables (e.g., one table per layer or multiple tables per layer) orother appropriate computer storage construct.

In some implementations, the tables may be updated as additional dosesare delivered. For example, a table may keep a running track of theamount of dose delivered at each location. So, if the beam dose is “X”grays, at a first scan pass, the table may record X grays for alocation. At a second scan pass, the table may record 2X grays, and soforth until the target cumulative dose is reached.

In this regard, for each location, a processing device associated withthe accelerator (e.g., the computer system that controls the particletherapy system) may compare the cumulative dose from a table, such asthat described above, to the target cumulative dose. If the cumulativedose matches the target cumulative dose, treatment for that location (orlayer) is deemed completed. If the cumulative dose does not match thetarget cumulative dose, additional treatment is performed. For example,the layer or location is scanned again at the same locations, which areobtained from the table. The linear correlation between magnet currentand beam movement produced by use of an air core magnet can facilitaterepeated, and relatively accurate, repeated scanning at the samelocations during multiple passes of the beam during scanning. The leavesof the adaptive aperture described herein may be moved slightly (e.g., afraction of a millimeter, a millimeter, or multiple millimeters) betweeneach scan of the same area, as described above.

Scanning may be repeated, at the same locations, any appropriate numberof times until the target cumulative dose is reached at each location.In this regard, the entire layer may be re-scanned or only selectportions of the layer may be re-scanned, dependent upon the targetcumulative doses for the different locations on the layer. In someimplementations, the intensity of the particle beam is not variedbetween scans. In other implementations, the intensity of the particlebeam may be varied between scans, particularly if a small dose isrequired to top-off a cumulative dose to reach the target cumulativedose. The intensity of the dose may be increased or decreased, e.g., byaltering the operation of the ion source (e.g., increasing the plasmaionization), altering the sweep of the RF frequency, or by any otherappropriate methods.

As noted, scanning may be repeated for an entire layer or for only aportion of a layer. In some implementations, an entire layer, or aportion thereof, may be fully treated before treating another layer.That is, scanning may be repeated until the total cumulative dose isreached for each location on a layer before another layer is treated. Insome implementations, each layer may be treated partially (e.g., scannedonce) in sequence, and then re-scanned in sequence. In someimplementations, several designated layers may be completely treatedbefore other layers are treated. In some implementations, the entiretarget may be scanned once, followed by successive scans of the entiretarget until the appropriate total cumulative dose is delivered to eachlocation. The adaptive aperture may be reconfigured for each scan or itsconfiguration may remain static between scans.

During movement between layers, the beam may be turned-off. For example,during movement between layers, the ion source may be turned-off,thereby disrupting the output of the beam. During movement betweenlayers, the RF sweep in the particle accelerator may be turned-off,thereby disrupting the extraction (and thus output) of the beam. Duringmovement between layers, both the ion source and the circuitry thatcreates the RF sweep may be deactivated in some implementations. In someimplementations, rather than turning-off the ion source and/or the RFsweep during movement between layers, the beam may be deflected to abeam-absorbing material using a kicker magnet (not shown) or thescanning magnet.

Different cross-sections of the irradiation target may be scannedaccording to different treatment plans. As described above, an energydegrader is used to control the scanning depth. In some implementations,the particle beam may be interrupted or redirected during configurationof the energy degrader. In other implementations, this need not be thecase.

Described herein are examples of treating cross-sections of anirradiation target. These may be cross-sections that are roughlyperpendicular to the direction of the particle beam. However, theconcepts described herein are equally applicable to treating otherportions of an irradiation target that are not cross-sectionsperpendicular to the direction of the particle beam. For example, anirradiation target may be segmented into spherical, cubical or othershaped volumes, and those volumes may be treated using the exampleprocesses, systems, and/or devices described herein.

FIG. 17 is a flowchart showing an example implementation of the scanningprocess described herein. Although process 200 of FIG. 17 is describedin the context of the hardware described herein, process 200 may beperformed using any appropriate hardware. The operations shown inprocess 200 may be performed in the same order as depicted or in adifferent order, where appropriate.

According to process 200, a treatment plan is stored (201). Thetreatment plan may be a treatment plan as described above. For example,the treatment plan may specify the type of scanning (e.g., uninterruptedraster scanning) and the total cumulative dose of radiation to bedelivered to each location in each layer of an irradiation target. Insome implementations, the treatment plan may omit, e.g., the doses to bedelivered for each scan at individual locations and their intensities,as well as the number of doses to be delivered to each location and theidentity of the locations. In some implementations, the treatment planmay include, e.g., the doses to be delivered for each scan at individuallocations and their intensities, as well as the number of doses to bedelivered to each location and the identity of the locations.

An energy degrader may be set to select (202) a layer, and current maybe applied to the magnet and controlled to move (203) the particle beamin accordance with a pattern set forth, e.g., in the treatment plan, toscan the layer. The current control may produce uninterrupted movementof the beam across at least part of the irradiation target to deliverdoses of charged particles. An example of a pattern of beam movement 230across a layer 233 of an irradiation target is shown in FIG. 18. As thebeam moves, each pulse of the beam delivers a dose of radiation to thetarget. The dose has an intensity, which may be set beforehand in theaccelerator or during scanning, and is delivered to specific positions.The exact positions at which dose is to be delivered need not be setbeforehand, but rather may be arrived at by a combination of beammovement and pulse output.

For positions at which the dose is delivered, information is stored(204) (or otherwise recorded), which identifies a location and an amountof dose delivered at the location. This information is typically storedafter the dose is delivered. As explained above, the information may bedetermined as close to delivery of the dose as possible, using the ionchamber to determine particle beam intensity (e.g., the amount of thedose) and the current sensor on the scanning magnet to determine thelocation at which the dose is delivered. As described above, in someimplementations, in synchronism with the delivery, informationidentifying doses of the particle beam delivered to the irradiationtarget is stored along with at least one of: coordinates at which thedoses were delivered or magnet currents at which the doses weredelivered. As also described above, this information may be stored intables, which may be used to store the cumulative dose of radiationapplied at positions on various layers of an irradiation target.

The entire layer may be scanned and information therefor recorded, asdescribed above, or only part of the layer may be scanned andinformation therefor recorded. The adaptive aperture is mounted on anappropriate location of the scanning system in such as manner as toenable the adaptive aperture to track the particle beam's movementduring scanning operations. At a point during scanning, the cumulativedose delivered at each position is compared to a target cumulative dosefor that position. For example, this may be done after part of a layercontaining that position is scanned, after the entire layer is scanned,after a set of layers are scanned, or after all layers in an irradiationtarget are scanned. It is determined (205) if the current cumulativedose matches the target cumulative dose at specific positions. If thecurrent cumulative dose does match the target cumulative dose atspecific positions, scanning is completed (207) for those positions. Ifthe current cumulative dose does not match the target cumulative dose atspecific positions, the scanning system is operated to compensate fordeficiencies in the recorded (e.g., current cumulative) doses relativeto corresponding target cumulative doses for those positions. Forexample, if the current cumulative dose does not match the targetcumulative dose at specific positions, the current in the scanningmagnet may be controlled in order to move (206) the beam so as todeliver additional dose to the specific positions.

As explained above, in some implementations, 100% of the dose may beapplied during a single scan (e.g., a single delivery of particles) of alayer. In that case, more than one scan per layer may not be necessary.In other implementations, less than 100% of the dose may be appliedduring a single scan. In that case, more than one scan per layer will benecessary. To this end, according to the scanning process, for positionsat which dose is applied, if the current cumulative dose at eachposition does not match the target cumulative dose at a correspondingposition, the magnet current is controlled in order to move the beam soas to deliver additional dose to positions that require more dose. Inother words, the layer may be re-scanned any appropriate number of timesuntil the target cumulative dose is reached for all positions of thelayer. In some implementations, in one scan or in multiple scans, theactual delivered dose may exceed 100% of the target cumulative dose.What dose to deliver may be dictated by appropriate medicalprofessionals.

As noted above, the layer may be re-scanned at any appropriate point,e.g., after part of the layer is completed with a current scan, afterthe entire layer is completed with the current scan, after a set oflayers is completed with a scan, or after all layers are completed witha scan. During re-scanning, the process above is repeated until thetarget cumulative dose is reached for all, or some subset of, positionsin the irradiation target. In some implementations, the intensity of theparticle beam may need to be adjusted, e.g., for the last scan. Forexample, if the intensity is set at 25% of the target cumulative dose,but only 20% is delivered at each scan, then a fifth (and possiblysixth) dose will require a lower intensity than 25% in order to reachthe target cumulative dose.

In some implementations, information from the TPP may be used toconfigure the adaptive aperture for an initial spot or series of spots.As described herein, configuring may include, for example, positioningcarriages 713, 714, and/or 715, and/or one or more of leaves 735 and/or736. In some implementations, the initial configuration may be madebased on assumptions included in the treatment planning processincluding, but not limited to, the position of the irradiation targetand patient during treatment. In some cases, however, the position ofthe irradiation target and patient during treatment may change relativeto the assumptions included in the TPP. For example, the patient maymove, breathing may impact target positions, and so forth. To accountfor these changes caused by movement, spot characteristics including,but not limited to, spot location, spot size, spot shape, spot weight,or spot orientation, may be correspondingly changed in order toimplement the treatment. In some implementations, rather than modifyinginputs to the TPP in order to make these changes via the TPP, thechanges may be made online—e.g., during treatment while the acceleratoris operational—without requiring any, or some, additional input from theTPP or the TPS.

For example, in some implementations, the position of the irradiationtarget may be tracked directly within the treatment room. For example,the treatment room may include one or more imaging systems to image andthereby track motion of the irradiation target. Examples of in-roomimaging systems that may be used to track motion of an irradiationtarget are described in U.S. Patent Publication No. 2016/0067525, whichwas filed on Sep. 9, 2014, and which is titled “Patient PositioningSystem”. U.S. Patent Publication No. 2016/0067525 is incorporated byreference, at least for its disclosure of systems used to locate, andtrack, motion of an irradiation target in a treatment room.

In some implementations, the imaging system can be a three-dimensional(3D) imaging system. In some implementations, the imaging system can bea two-dimensional (2D) imaging system. In some implementations, theimaging system may be, or include, one or more of the following types ofimaging systems: a CT system, an X-ray device to capture a radiographimage, a magnetic resonance imaging (MRI) device to capture an MRIimage, a positron emission tomography (PET) device to capture a PETimage, a SPECT/CT device (where SPECT is Single-photon emission computedtomography), and/or a video surface imaging device, or any combinationof these imaging devices. In some implementations, images may becaptured at different points in time so as to enable tracking ofmovement of the irradiation target. In some implementations, fiducialsassociated the patient and proximate to an irradiation target may beused to detect motion of the patient and/or irradiation target. Thelocation of the fiducials relative to the target may be known, andmovement of the fiducials may be detected and correlated to movement ofthe irradiation target. In some implementations, the irradiation targetmay be imaged directly at two different points in time.

In some implementations, movement may be tracked between application ofindividual spots on a single layer, between application of sets of spots(e.g., a predefined number of spots) on a single layer, between layers,or between some appropriate combination of the foregoing. Referring toexample process 2500 of FIG. 43, an image of an irradiation target orpatient is captured (2501) in order to determine the location of theirradiation target. The particle therapy system receives (2502)information from a TPP/TPS that is used to produce (2503) a spot or setof spots on the irradiation target at appropriate locations based on theinformation. Thereafter, an image of an irradiation target or patient iscaptured (2504) in order to determine (2505) whether the irradiationtarget has moved since a prior image was captured. In someimplementations, an X-ray system may be used to capture the image;however, any appropriate imaging system including, but not limited to,those described herein may be used. An irradiation target is deemed tohave moved if the irradiation target is not in the same location, e.g.,relative to some reference point, such as a fiducial, between images. Ifthe irradiation target has not moved, one or more spots are produced(2503) using the most current treatment planning information. Forexample, the most current treatment planning information may be theinformation received (2502) from the TPP/TPS, or the most currenttreatment planning information may be the information as modified (2506)to account for prior movement. If the irradiation target has moved, thetreatment planning information is modified (2506) to produce updatedtreatment planning information based on the movement of the irradiationtarget. Thereafter, spots are produced using the updated treatmentplanning information. The process may proceed as shown in FIG. 43 untilthe entire target is treated.

Thus, in some implementations, the TPP need not be re-run using newinformation, such as the newly-determined location of the irradiationtarget. Instead, in some implementations, the information from theTPP/TPS used to produce the spots is modified or changed (2506), e.g.,in real-time, to account for the movement of the irradiation target. Forexample, the information may be changed while a particle accelerator,such as a synchrocyclotron, used to provide the treatment is online. Anyappropriate information may be changed including, but not limited to,spot location, spot size, spot shape, spot weight, or spot orientation.For example, the locations of spots may be changed to account formovement of the irradiation target. In another example, the direction ofapplication of particles to the irradiation target may be changed toaccount for movement of the irradiation target.

The processes described herein may be used with a single particleaccelerator, and any two or more of the features thereof describedherein may be used with the single particle accelerator. The particleaccelerator may be used in any type of medical or non-medicalapplication. Examples of particle therapy systems that may be used areprovided below. Notably, the concepts described herein may be used inother systems not specifically described.

Referring to FIG. 19, an example implementation of a charged particleradiation therapy system 400 includes a beam-producing particleaccelerator 402 (e.g., the particle accelerator of FIGS. 8 and 9) havinga weight and size small enough to permit it to be mounted on a rotatinggantry 404 with its output directed straight (that is, essentiallydirectly) from the accelerator housing toward a patient 406. Particleaccelerator 402 also includes a scanning system of a type describedherein (e.g., in FIGS. 10 to 18).

In some implementations, the steel gantry has two legs 408, 410 mountedfor rotation on two respective bearings 412, 414 that lie on oppositesides of the patient. The accelerator is supported by a steel truss 416that is long enough to span a treatment area 418 in which the patientlies (e.g., twice as long as a tall person, to permit the person to berotated fully within the space with any desired target area of thepatient remaining in the line of the beam) and is attached stably atboth ends to the rotating legs of the gantry.

In some examples, the rotation of the gantry is limited to a range 420of less than 360 degrees, e.g., about 180 degrees, to permit a floor 422to extend from a wall of a vault 424 that houses the therapy system intothe patient treatment area. The limited rotation range of the gantryalso reduces the required thickness of some of the walls (which are notdirectly aligned with the beam, e.g., wall 430), which provide radiationshielding of people outside the treatment area. A range of 180 degreesof gantry rotation is enough to cover all treatment approach angles, butproviding a larger range of travel can be useful. For example the rangeof rotation may be between 180 and 330 degrees and still provideclearance for the therapy floor space. In other implementations,rotation is not limited as described above.

The horizontal rotational axis 432 of the gantry is located nominallyone meter above the floor where the patient and therapist interact withthe therapy system. This floor is positioned about 3 meters above thebottom floor of the therapy system shielded vault. The accelerator canswing under the raised floor for delivery of treatment beams from belowthe rotational axis. The patient couch moves and rotates in asubstantially horizontal plane parallel to the rotational axis of thegantry. The couch can rotate through a range 434 of about 270 degrees inthe horizontal plane with this configuration. This combination of gantryand patient rotational ranges and degrees of freedom allows thetherapist to select virtually any approach angle for the beam. Ifneeded, the patient can be placed on the couch in the oppositeorientation and then all possible angles can be used.

In some implementations, the accelerator uses a synchrocyclotronconfiguration having a high magnetic field superconductingelectromagnetic structure. Because the bend radius of a charged particleof a given kinetic energy is reduced in direct proportion to an increasein the magnetic field applied to it, the high magnetic fieldsuperconducting magnetic structure permits the accelerator to be madesmaller and lighter. The synchrocyclotron uses a magnetic field that isuniform in rotation angle and falls off in strength with increasingradius. Such a field shape can be achieved regardless of the magnitudeof the magnetic field, so in theory there is no upper limit to themagnetic field strength (and therefore the resulting particle energy ata fixed radius) that can be used in a synchrocyclotron.

The synchrocyclotron is supported on the gantry so that the beam isgenerated directly in line with the patient. The gantry permits rotationof the synchrocyclotron about a horizontal rotational axis that containsa point (isocenter 440) within, or near, the patient. The split trussthat is parallel to the rotational axis, supports the synchrocyclotronon both sides.

Because the rotational range of the gantry is limited in some exampleimplementations, a patient support area can be accommodated in a widearea around the isocenter. Because the floor can be extended broadlyaround the isocenter, a patient support table can be positioned to moverelative to and to rotate about a vertical axis 442 through theisocenter so that, by a combination of gantry rotation and table motionand rotation, any angle of beam direction into any part of the patientcan be achieved. In some implementations, the two gantry arms areseparated by more than twice the height of a tall patient, allowing thecouch with patient to rotate and translate in a horizontal plane abovethe raised floor.

Limiting the gantry rotation angle allows for a reduction in thethickness of at least one of the walls surrounding the treatment room.Thick walls, typically constructed of concrete, provide radiationprotection to individuals outside the treatment room. A wall downstreamof a stopping proton beam may be about twice as thick as a wall at theopposite end of the room to provide an equivalent level of protection.Limiting the range of gantry rotation enables the treatment room to besited below earth grade on three sides, while allowing an occupied areaadjacent to the thinnest wall reducing the cost of constructing thetreatment room.

In the example implementation shown in FIG. 19, the superconductingsynchrocyclotron 402 operates with a peak magnetic field in a pole gapof the synchrocyclotron of 8.8 Tesla. The synchrocyclotron produces abeam of protons having an energy of 250 MeV. In some implementations,the synchrocyclotron is a variable-energy machine, and is capable ofoutputting proton beams having different energies. In someimplementations, the synchrocyclotron may produce a beam having a fixedenergy. In some implementations the field strength could be in the rangeof 4 T to 20 T and the proton energy could be in the range of 100 to 300MeV.

The radiation therapy system described in this example is used forproton radiation therapy, but the same principles and details can beapplied in analogous systems for use in heavy ion (ion) treatmentsystems.

As shown in FIGS. 8, 9, 20, 21, and 22, an example synchrocyclotron 10(e.g., 402 in FIG. 19) includes a magnet system 122 that contains aparticle source 190, a radiofrequency drive system 191, and a beamextraction system. In this example, the magnetic field established bythe magnet system has a shape appropriate to maintain focus of acontained proton beam using a combination of a split pair of annularsuperconducting coils 140, 142 and a pair of shaped ferromagnetic (e.g.,low carbon steel) pole faces 144, 146.

The two superconducting magnet coils are centered on a common axis andare spaced apart along the axis. The coils may be formed by ofNb₃Sn-based superconducting strands (that initially comprise aniobium-tin core surrounded by a copper sheath) deployed in a twistedcable-in-channel conductor geometry. After individual strands are cabledtogether, they are heated to cause a reaction that forms the final(brittle) superconducting material of the wire. After the material hasbeen reacted, the wires are soldered into the copper channel and coveredwith insulation. The copper channel containing the wires is then woundin a coil having a rectangular cross-section. The wound coil is thenvacuum impregnated with an epoxy compound. The finished coils aremounted on an annular stainless steel reverse bobbin. Heater blanketsmay be placed at intervals in the layers of the windings to protect theassembly in the event of a magnet quench.

The entire coil can then be covered with copper sheets to providethermal conductivity and mechanical stability and then contained in anadditional layer of epoxy. The precompression of the coil can beprovided by heating the stainless steel reverse bobbin and fitting thecoils within the reverse bobbin. The reverse bobbin inner diameter ischosen so that when the entire mass is cooled to 4 K, the reverse bobbinstays in contact with the coil and provides some compression. Heatingthe stainless steel reverse bobbin to approximately 50 degrees C. andfitting coils at a temperature of 100 degrees Kelvin can achieve this.

The geometry of the coil is maintained by mounting the coils in a“reverse” rectangular bobbin to exert a restorative force that worksagainst the distorting force produced when the coils are energized. Asshown in FIG. 21, in some implementations, coil position is maintainedrelative to corresponding magnet pole pieces and the cryostat using aset of warm-to-cold support straps 402, 404, 406. Supporting the coldmass with thin straps reduces the heat leakage imparted to the cold massby the rigid support system. The straps are arranged to withstand thevarying gravitational force on the coil as the magnet rotates on boardthe gantry. They withstand the combined effects of gravity and the largede-centering force realized by the coil when it is perturbed from aperfectly symmetric position relative to the magnet yoke. Additionally,the links act to reduce dynamic forces imparted on the coil as thegantry accelerates and decelerates when its position is changed. Eachwarm-to-cold support may include one S2 fiberglass link and one carbonfiber link. The carbon fiber link is supported across pins between thewarm yoke and an intermediate temperature (50-70 K), and the S2fiberglass link 408 is supported across the intermediate temperature pinand a pin attached to the cold mass. Each pin may be made of highstrength stainless steel.

Referring to FIG. 8, the field strength profile as a function of radiusis determined largely by choice of coil geometry and pole face shape.The pole faces 144, 146 of the permeable yoke material can be contouredto fine tune the shape of the magnetic field to ensure that the particlebeam remains focused during acceleration.

The superconducting coils are maintained at temperatures near absolutezero (e.g., about 4 degrees Kelvin) by enclosing the coil assembly (thecoils and the bobbin) inside an evacuated annular aluminum or stainlesssteel cryostatic chamber 170 (the cryostat) that provides a free spacearound the coil structure, except at a limited set of support points171, 173. In an alternate version (e.g., FIG. 9) the outer wall of thecryostat may be made of low carbon steel to provide an additional returnflux path for the magnetic field.

In some implementations, the temperature near absolute zero is achievedand maintained using one single-stage Gifford-McMahon cryo-cooler andthree two-stage Gifford McMahon cryo-coolers. Each two stage cryo-coolerhas a second stage cold end attached to a condenser that recondensesHelium vapor into liquid Helium. In some implementations, thetemperature near absolute zero is achieved and maintained using acooling channel (not shown) containing liquid helium, which is formedinside a superconducting coil support structure (e.g., the reversebobbin 156), and which contains a thermal connection between the liquidhelium in the channel and the corresponding superconducting coil.

In some implementations, the coil assembly and cryostatic chambers aremounted within and fully enclosed by two halves 181, 183 of apillbox-shaped magnet yoke 100. The yoke 100 provides a path for thereturn magnetic field flux 184 and magnetically shields the volume 186between the pole faces 144, 146 to prevent external magnetic influencesfrom perturbing the shape of the magnetic field within that volume. Theyoke also serves to decrease the stray magnetic field in the vicinity ofthe accelerator. In other implementations, the coil assembly andcryostatic chambers are mounted within and fully enclosed by anon-magnetic enclosure, and the path for return magnetic field flux isimplemented using an active return system, an example of which isdescribed above.

As shown in FIGS. 8 and 23, the synchrocyclotron includes a particlesource 190 of a Penning ion gauge geometry located near the geometriccenter 192 of the magnet structure. The particle source may be asdescribed below.

Particle source 190 is fed from a supply 399 of hydrogen through a gasline 393 and tube 394 that delivers gaseous hydrogen. Electric cables294 carry an electric current from a current source to stimulateelectron discharge from cathodes 392, 390 that are aligned with themagnetic field. Particle source may be interrupted at the accelerationplane, e.g., the entirety of the particle source may be removed, therebyexposing the plasma column.

In this example, the discharged electrons ionize the gas exiting througha small hole from tube 394 to create a supply of positive ions (protons)for acceleration by one semicircular (dee-shaped) radio-frequency platethat spans half of the space enclosed by the magnet structure and onedummy dee plate. In the case of an interrupted particle source, all (ora substantial part, e.g., a majority) of the tube containing plasma isremoved at the acceleration region.

As shown in FIG. 24, the dee plate 500 is a hollow metal structure thathas two semicircular surfaces 503, 505 that enclose a space 507 in whichthe protons are accelerated during half of their rotation around thespace enclosed by the magnet structure. A duct 509 opening into thespace 507 extends through the enclosure (e.g., the yoke or polepiece(s)) to an external location from which a vacuum pump can beattached to evacuate the space 507 and the rest of the space within avacuum chamber in which the acceleration takes place. The dummy dee 502comprises a rectangular metal ring that is spaced near to the exposedrim of the dee plate. The dummy dee is grounded to the vacuum chamberand magnet yoke. The dee plate 500 is driven by a radio-frequency signalthat is applied at the end of a radio-frequency transmission line toimpart an electric field in the space 507. The radio frequency electricfield is made to vary in time as the accelerated particle beam increasesin distance from the geometric center.

For the beam emerging from the centrally located particle source toclear the particle source structure as it begins to spiral outward, alarge voltage difference may be applied across the radio frequencyplates. 20,000 Volts is applied across the radio frequency plates. Insome versions from 8,000 to 20,000 Volts may be applied across the radiofrequency plates. To reduce the power required to drive this largevoltage, the magnet structure is arranged to reduce the capacitancebetween the radio frequency plates and ground. This may be done byforming holes with sufficient clearance from the radio frequencystructures through the outer yoke and the cryostat housing and makingsufficient space between the magnet pole faces.

The high voltage alternating potential that drives the dee plate has afrequency that is swept downward during the accelerating cycle toaccount for the increasing relativistic mass of the protons and thedecreasing magnetic field. The dummy dee does not require a hollowsemi-cylindrical structure as it is at ground potential along with thevacuum chamber walls. Other plate arrangements could be used such asmore than one pair of accelerating electrodes driven with differentelectrical phases or multiples of the fundamental frequency. The RFstructure can be tuned to keep the Q high during the required frequencysweep by using, for example, a rotating capacitor having intermeshingrotating and stationary blades. During each meshing of the blades, thecapacitance increases, thus lowering the resonant frequency of the RFstructure. The blades can be shaped to create a precise frequency sweeprequired. A drive motor for the rotating condenser can be phase lockedto the RF generator for precise control. One bunch of particles may beaccelerated during each meshing of the blades of the rotating condenser.

The vacuum chamber in which the acceleration occurs is a generallycylindrical container that is thinner in the center and thicker at therim. The vacuum chamber encloses the RF plates and the particle sourceand is evacuated by a vacuum pump. Maintaining a high vacuum reduces thechances that accelerating ions are not lost to collisions with gasmolecules and enables the RF voltage to be kept at a higher levelwithout arcing to ground.

Protons (or other ions) traverse a generally spiral orbital pathbeginning at the particle source. In half of each loop of the spiralpath, the protons gain energy as they pass through the RF electricfield. As the protons gain energy, the radius of the central orbit ofeach successive loop of their spiral path is larger than the prior loopuntil the loop radius reaches the maximum radius of the pole face. Atthat location a magnetic and electric field perturbation directs protonsinto an area where the magnetic field rapidly decreases, and the protonsdepart the area of the high magnetic field and are directed through anevacuated tube, referred to herein as the extraction channel, to exitthe synchrocyclotron. A magnetic regenerator may be used to change themagnetic field perturbation to direct the protons. The protons exitingwill tend to disperse as they enter an area of markedly decreasedmagnetic field that exists in the room around the synchrocyclotron. Beamshaping elements 607, 609 in the extraction channel 138 (FIG. 21)redirect the protons so that they stay in a straight beam of limitedspatial extent.

As the beam exits the extraction channel it is passed through a beamformation system 525 (FIG. 21), which may include a scanning system ofthe type described herein. Beam formation system 525 may be used inconjunction with an inner gantry that controls application of the beam.

Stray magnetic fields exiting from the synchrocyclotron may be limitedby both a magnet yoke (which also serves as a shield) and a separatemagnetic shield 514 (e.g., FIG. 8). The separate magnetic shieldincludes of a layer 517 of ferromagnetic material (e.g., steel or iron)that encloses the pillbox yoke, separated by a space 516. Thisconfiguration that includes a sandwich of a yoke, a space, and a shieldachieves adequate shielding for a given leakage magnetic field at lowerweight. As described above, in some implementations, an active returnsystem may be used in place of, or to augment, the operation of themagnetic yoke and shield.

Referring to FIG. 19, the gantry allows the synchrocyclotron to berotated about a horizontal rotational axis 432. The truss structure 416has two generally parallel spans 480, 482. The synchrocyclotron iscradled between the spans about midway between the legs. The gantry isbalanced for rotation about the bearings using counterweights 622, 624mounted on ends of the legs opposite the truss.

The gantry is driven to rotate by an electric motor mounted to one orboth of the gantry legs and connected to the bearing housings by drivegears. The rotational position of the gantry is derived from signalsprovided by shaft angle encoders incorporated into the gantry drivemotors and the drive gears.

At the location at which the ion beam exits the synchrocyclotron, thebeam formation system 525 acts on the ion beam to give it propertiessuitable for patient treatment. For example, the beam may be spread andits depth of penetration varied to provide uniform radiation across agiven target volume. The beam formation system may include activescanning elements as described herein.

All of the active systems of the synchrocyclotron (the current drivensuperconducting coils, the RF-driven plates, the vacuum pumps for thevacuum acceleration chamber and for the superconducting coil coolingchamber, the current driven particle source, the hydrogen gas source,and the RF plate coolers, for example), may be controlled by appropriatesynchrocyclotron control electronics (not shown), which may include,e.g., one or more processing devices executing instructions fromnon-transitory memory to effect control.

The particle accelerator used in the example particle therapy systemsand example scanning systems described herein may be a variable-energyparticle accelerator, an example of which is described below

The energy of an extracted particle beam (the particle beam output fromthe accelerator) can affect the use of the particle beam duringtreatment. In some machines, the energy of the particle beam (orparticles in the particle beam) does not increase after extraction.However, the energy may be reduced based on treatment needs after theextraction and before the treatment. Referring to FIG. 25, an exampletreatment system 910 includes an accelerator 912, e.g., asynchrocyclotron, from which a particle (e.g., proton) beam 914 having avariable energy is extracted to irradiate a target volume 924 of a body922. Optionally, one or more additional devices, such as a scanning unit916 or a scattering unit 916, one or more monitoring units 918, and anenergy degrader 920, are placed along the irradiation direction 928. Thedevices intercept the cross-section of the extracted beam 914 and alterone or more properties of the extracted beam for the treatment. Theadaptive aperture may be located down-beam of the energy degrader,between the energy degrader and the patient.

A target volume to be irradiated (an irradiation target) by a particlebeam for treatment typically has a three-dimensional configuration. Insome examples, to carry-out the treatment, the target volume is dividedinto layers along the irradiation direction of the particle beam so thatthe irradiation can be done on a layer-by-layer basis. For certain typesof particles, such as protons, the penetration depth (or which layer thebeam reaches) within the target volume is largely determined by theenergy of the particle beam. A particle beam of a given energy does notreach substantially beyond a corresponding penetration depth for thatenergy. To move the beam irradiation from one layer to another layer ofthe target volume, the energy of the particle beam is changed.

In the example shown in FIG. 25, the target volume 924 is divided intonine layers 926 a-926 i along the irradiation direction 928. In anexample process, the irradiation starts from the deepest layer 926 i,one layer at a time, gradually to the shallower layers and finishes withthe shallowest layer 926 a. Before application to the body 922, theenergy of the particle beam 914 is controlled to be at a level to allowthe particle beam to stop at a desired layer, e.g., the layer 926 d,without substantially penetrating further into the body or the targetvolume, e.g., the layers 926 e-926 i or deeper into the body. In someexamples, the desired energy of the particle beam 914 decreases as thetreatment layer becomes shallower relative to the particle acceleration.In some examples, the beam energy difference for treating adjacentlayers of the target volume 924 is about 3 MeV to about 100 MeV, e.g.,about 10 MeV to about 80 MeV, although other differences may also bepossible, depending on, e.g., the thickness of the layers and theproperties of the beam.

The energy variation for treating different layers of the target volume924 can be performed at the accelerator 912 (e.g., the accelerator canvary the energy) so that, in some implementations, no additional energyvariation is required after the particle beam is extracted from theaccelerator 912. So, the optional energy degrader 920 in the treatmentsystem 10 may be eliminated from the system. In some implementations,the accelerator 912 can output particle beams having an energy thatvaries between about 100 MeV and about 300 MeV, e.g., between about 115MeV and about 250 MeV. The variation can be continuous ornon-continuous, e.g., one step at a time. In some implementations, thevariation, continuous or non-continuous, can take place at a relativelyhigh rate, e.g., up to about 50 MeV per second or up to about 20 MeV persecond. Non-continuous variation can take place one step at a time witha step size of about 10 MeV to about 90 MeV.

When irradiation is complete in one layer, the accelerator 912 can varythe energy of the particle beam for irradiating a next layer, e.g.,within several seconds or within less than one second. In someimplementations, the treatment of the target volume 924 can be continuedwithout substantial interruption or even without any interruption. Insome situations, the step size of the non-continuous energy variation isselected to correspond to the energy difference needed for irradiatingtwo adjacent layers of the target volume 924. For example, the step sizecan be the same as, or a fraction of, the energy difference.

In some implementations, the accelerator 912 and the degrader 920collectively vary the energy of the beam 914. For example, theaccelerator 912 provides a coarse adjustment and the degrader 920provides a fine adjustment or vice versa. In this example, theaccelerator 912 can output the particle beam that varies energy with avariation step of about 10-80 MeV, and the degrader 920 adjusts (e.g.,reduces) the energy of the beam at a variation step of about 2-10 MeV.

The reduced use (or absence) of the energy degrader, such as a rangemodulator, may help to maintain properties and quality of the outputbeam from the accelerator, e.g., beam intensity. The control of theparticle beam can be performed at the accelerator. Side effects, e.g.,from neutrons generated when the particle beam passes the degrader 920can be reduced or eliminated.

The energy of the particle beam 914 may be adjusted to treat anothertarget volume 930 in another body or body part 922′ after completingtreatment in target volume 924. The target volumes 924, 930 may be inthe same body (or patient), or in different patients. It is possiblethat the depth D of the target volume 930 from a surface of body 922′ isdifferent from that of the target volume 924. Although some energyadjustment may be performed by the degrader 920, the degrader 912 mayonly reduce the beam energy and not increase the beam energy.

In this regard, in some cases, the beam energy required for treatingtarget volume 930 is greater than the beam energy required to treattarget volume 924. In such cases, the accelerator 912 may increase theoutput beam energy after treating the target volume 924 and beforetreating the target volume 930. In other cases, the beam energy requiredfor treating target volume 930 is less than the beam energy required totreat target volume 924. Although the degrader 920 can reduce theenergy, the accelerator 912 can be adjusted to output a lower beamenergy to reduce or eliminate the use of the degrader 920. The divisionof the target volumes 924, 930 into layers can be different or the same.The target volume 930 can be treated similarly on a layer by layer basisto the treatment of the target volume 924.

The treatment of the different target volumes 924, 930 on the samepatient may be substantially continuous, e.g., with the stop timebetween the two volumes being no longer than about 30 minutes or less,e.g., 25 minutes or less, 20 minutes or less, 15 minutes or less, 10minutes or less, 5 minutes or less, or 1 minute or less. As explainedherein, the accelerator 912 can be mounted on a movable gantry and themovement of the gantry can move the accelerator to aim at differenttarget volumes. In some situations, the accelerator 912 can complete theenergy adjustment of the output beam 914 during the time the treatmentsystem makes adjustment (such as moving the gantry) after completing thetreatment of the target volume 924 and before starting treating thetarget volume 930. After the alignment of the accelerator and the targetvolume 930, the treatment can begin with the adjusted, desired beamenergy. Beam energy adjustment for different patients can also becompleted relatively efficiently. In some examples, all adjustments,including increasing/reducing beam energy and/or moving the gantry aredone within about 30 minutes, e.g., within about 25 minutes, withinabout 20 minutes, within about 15 minutes, within about 10 minutes orwithin about 5 minutes.

In the same layer of a target volume, an irradiation dose may be appliedby moving the beam across the two-dimensional surface of the layer(which is sometimes called scanning beam) using a scanning unit 916.Alternatively, the layer can be irradiated by passing the extracted beamthrough one or more scatterers of the scattering unit 16 (which issometimes called scattering beam).

Beam properties, such as energy and intensity, can be selected before atreatment or can be adjusted during the treatment by controlling theaccelerator 912 and/or other devices, such as the scanningunit/scatterer(s) 916, the degrader 920, and others not shown in thefigures. In example implementations, system 910 includes a controller932, such as a computer, in communication with one or more devices inthe system. Control can be based on results of the monitoring performedby the one or more monitors 918, e.g., monitoring of the beam intensity,dose, beam location in the target volume, etc. Although the monitors 918are shown to be between the device 916 and the degrader 920, one or moremonitors can be placed at other appropriate locations along the beamirradiation path. Controller 932 can also store a treatment plan for oneor more target volumes (for the same patient and/or different patients).The treatment plan can be determined before the treatment starts and caninclude parameters, such as the shape of the target volume, the numberof irradiation layers, the irradiation dose for each layer, the numberof times each layer is irradiated, etc. The adjustment of a beamproperty within the system 910 can be performed based on the treatmentplan. Additional adjustment can be made during the treatment, e.g., whendeviation from the treatment plan is detected.

In some implementations, the accelerator 912 is configured to vary theenergy of the output particle beam by varying the magnetic field inwhich the particle beam is accelerated. In an example implementation,one or more sets of coils receives variable electrical current toproduce a variable magnetic field in the cavity. In some examples, oneset of coils receives a fixed electrical current, while one or moreother sets of coils receives a variable current so that the totalcurrent received by the coil sets varies. In some implementations, allsets of coils are superconducting. In other implementations, some setsof coils, such as the set for the fixed electrical current, aresuperconducting, while other sets of coils, such as the one or more setsfor the variable current, are non-superconducting. In some examples, allsets of coils are non-superconducting.

Generally, the magnitude of the magnetic field is scalable with themagnitude of the electrical current. Adjusting the total electriccurrent of the coils in a predetermined range can generate a magneticfield that varies in a corresponding, predetermined range. In someexamples, a continuous adjustment of the electrical current can lead toa continuous variation of the magnetic field and a continuous variationof the output beam energy. Alternatively, when the electrical currentapplied to the coils is adjusted in a non-continuous, step-wise manner,the magnetic field and the output beam energy also varies accordingly ina non-continuous (step-wise) manner. The scaling of the magnetic fieldto the current can allow the variation of the beam energy to be carriedout relatively precisely, although sometimes minor adjustment other thanthe input current may be performed.

In some implementations, to output particle beams having a variableenergy, the accelerator 912 is configured to apply RF voltages thatsweep over different ranges of frequencies, with each rangecorresponding to a different output beam energy. For example, if theaccelerator 912 is configured to produce three different output beamenergies, the RF voltage is capable of sweeping over three differentranges of frequencies. In another example, corresponding to continuousbeam energy variations, the RF voltage sweeps over frequency ranges thatcontinuously change. The different frequency ranges may have differentlower frequency and/or upper frequency boundaries.

The extraction channel may be configured to accommodate the range ofdifferent energies produced by the variable-energy particle accelerator.For example the extraction channel may be large enough to support thehighest and lowest energies produced by the particle accelerator. Thatis, the extraction channel may be sized or otherwise configured toreceive and to transmit particles within that range of energies.Particle beams having different energies can be extracted from theaccelerator 912 without altering the features of the regenerator that isused for extracting particle beams having a single energy. In otherimplementations, to accommodate the variable particle energy, theregenerator can be moved to disturb (e.g., change) different particleorbits in the manner described above and/or iron rods (magnetic shims)can be added or removed to change the magnetic field bump provided bythe regenerator. More specifically, different particle energies willtypically be at different particle orbits within the cavity. By movingthe regenerator, it is possible to intercept a particle orbit at aspecified energy and thereby provide the correct perturbation of thatorbit so that particles at the specified energy reach the extractionchannel. In some implementations, movement of the regenerator (and/oraddition/removal of magnetic shims) is performed in real-time to matchreal-time changes in the particle beam energy output by the accelerator.In other implementations, particle energy is adjusted on a per-treatmentbasis, and movement of the regenerator (and/or addition/removal ofmagnetic shims) is performed in advance of the treatment. In eithercase, movement of the regenerator (and/or addition/removal of magneticshims) may be computer controlled. For example, a computer may controlone or more motors that effect movement of the regenerator and/ormagnetic shims.

In some implementations, the regenerator is implemented using one ormore magnetic shims that are controllable to move to the appropriatelocation(s).

As an example, table 1 shows three example energy levels at whichexample accelerator 912 can output particle beams. The correspondingparameters for producing the three energy levels are also listed. Inthis regard, the magnet current refers to the total electrical currentapplied to the one or more coil sets in the accelerator 912; the maximumand minimum frequencies define the ranges in which the RF voltagesweeps; and “r” is the radial distance of a location to a center of thecavity in which the particles are accelerated.

TABLE 1 Examples of beam energies and respective parameters. MagneticMagnetic Beam Magnet Maximum Minimum Field at Field at Energy CurrentFrequency Frequency r = 0 mm r = 298 mm (MeV) (Amps) (MHz) (MHz) (Tesla)(Tesla) 250 1990 132 99 8.7 8.2 235 1920 128 97 8.4 8.0 211 1760 120 937.9 7.5

The accelerator may be a synchrocyclotron and the particles may beprotons. The particles may be output as pulsed beams. The energy of thebeam output from the particle accelerator can be varied during thetreatment of one target volume in a patient, or between treatments ofdifferent target volumes of the same patient or different patients. Insome implementations, settings of the accelerator are changed to varythe beam energy when no beam (or particles) is output from theaccelerator. The energy variation can be continuous or non-continuousover a desired range.

Referring to the example shown in FIG. 8, the particle accelerator,which may be a variable-energy particle accelerator like accelerator 912described above, may be configured to output particle beams that have avariable energy. The range of the variable energy can have an upperboundary that is about 200 MeV to about 300 MeV or higher, e.g., 200MeV, about 205 MeV, about 210 MeV, about 215 MeV, about 220 MeV, about225 MeV, about 230 MeV, about 235 MeV, about 240 MeV, about 245 MeV,about 250 MeV, about 255 MeV, about 260 MeV, about 265 MeV, about 270MeV, about 275 MeV, about 280 MeV, about 285 MeV, about 290 MeV, about295 MeV, or about 300 MeV or higher. The range can also have a lowerboundary that is about 100 MeV or lower to about 200 MeV, e.g., about100 MeV or lower, about 105 MeV, about 110 MeV, about 115 MeV, about 120MeV, about 125 MeV, about 130 MeV, about 135 MeV, about 140 MeV, about145 MeV, about 150 MeV, about 155 MeV, about 160 MeV, about 165 MeV,about 170 MeV, about 175 MeV, about 180 MeV, about 185 MeV, about 190MeV, about 195 MeV, about 200 MeV.

In some examples, the variation is non-continuous and the variation stepcan have a size of about 10 MeV or lower, about 15 MeV, about 20 MeV,about 25 MeV, about 30 MeV, about 35 MeV, about 40 MeV, about 45 MeV,about 50 MeV, about 55 MeV, about 60 MeV, about 65 MeV, about 70 MeV,about 75 MeV, or about 80 MeV or higher. Varying the energy by one stepsize can take no more than 30 minutes, e.g., about 25 minutes or less,about 20 minutes or less, about 15 minutes or less, about 10 minutes orless, about 5 minutes or less, about 1 minute or less, or about 30seconds or less. In other examples, the variation is continuous and theaccelerator can adjust the energy of the particle beam at a relativelyhigh rate, e.g., up to about 50 MeV per second, up to about 45 MeV persecond, up to about 40 MeV per second, up to about 35 MeV per second, upto about 30 MeV per second, up to about 25 MeV per second, up to about20 MeV per second, up to about 15 MeV per second, or up to about 10 MeVper second. The accelerator can be configured to adjust the particleenergy both continuously and non-continuously. For example, acombination of the continuous and non-continuous variation can be usedin a treatment of one target volume or in treatments of different targetvolumes. Flexible treatment planning and flexible treatment can beachieved.

A particle accelerator that outputs a particle beam having a variableenergy can provide accuracy in irradiation treatment and reduce thenumber of additional devices (other than the accelerator) used for thetreatment. For example, the use of degraders for changing the energy ofan output particle beam may be reduced or eliminated for all or part ofthe treatment. The properties of the particle beam, such as intensity,focus, etc. can be controlled at the particle accelerator and theparticle beam can reach the target volume without substantialdisturbance from the additional devices. The relatively high variationrate of the beam energy can reduce treatment time and allow forefficient use of the treatment system.

In some implementations, the accelerator, such as the synchrocyclotronof FIG. 8, accelerates particles or particle beams to variable energylevels by varying the magnetic field in the accelerator, which can beachieved by varying the electrical current applied to coils forgenerating the magnetic field. As explained above, an examplesynchrocyclotron (e.g., the synchrocyclotron of FIG. 8) includes amagnet system that contains a particle source, a radiofrequency drivesystem, and a beam extraction system. FIG. 26 shows an example of amagnet system that may be used in a variable-energy accelerator. In thisexample implementation, the magnetic field established by the magnetsystem 1012 can vary by about 5% to about 35% of a maximum value of themagnetic field that two sets of coils 40 a and 40 b, and 42 a and 42 bare capable of generating. The magnetic field established by the magnetsystem has a shape appropriate to maintain focus of a contained protonbeam using a combination of the two sets of coils and a pair of shapedferromagnetic (e.g., low carbon steel) structures, examples of which areprovided above.

Each set of coils may be a split pair of annular coils to receiveelectrical current. In some situations, both sets of coils aresuperconducting. In other situations, only one set of the coils issuperconducting and the other set is non-superconducting or normalconducting (also discussed further below). It is also possible that bothsets of coils are non-superconducting. Suitable superconductingmaterials for use in the coils include niobium-3 tin (Nb3Sn) and/orniobium-titanium. Other example conducting materials can include copper.Examples of the coil set constructions are described further below.

The two sets of coils can be electrically connected serially or inparallel. In some implementations, the total electrical current receivedby the two sets of coils can include about 2 million ampere turns toabout 10 million ampere turns, e.g., about 2.5 to about 7.5 millionampere turns or about 3.75 million ampere turns to about 5 millionampere turns. In some examples, one set of coils is configured toreceive a fixed (or constant) portion of the total variable electricalcurrent, while the other set of coils is configured to receive avariable portion of the total electrical current. The total electricalcurrent of the two coil sets varies with the variation of the current inone coil set. In other situations, the electrical current applied toboth sets of coils can vary. The variable total current in the two setsof coils can generate a magnetic field having a variable magnitude,which in turn varies the acceleration pathways of the particles andproduces particles having variable energies.

Generally, the magnitude of the magnetic field generated by the coil(s)is scalable to the magnitude of the total electrical current applied tothe coil(s). Based on the scalability, in some implementations, linearvariation of the magnetic field strength can be achieved by linearlychanging the total current of the coil sets. The total current can beadjusted at a relatively high rate that leads to a relatively high-rateadjustment of the magnetic field and the beam energy.

In the example reflected in Table 1 above, the ratio between values ofthe current and the magnetic field at the geometric center of the coilrings is: 1990:8.7 (approximately 228.7:1); 1920:8.4 (approximately228.6:1); 1760:7.9 (approximately 222.8:1). Accordingly, adjusting themagnitude of the total current applied to a superconducting coil(s) canproportionally (based on the ratio) adjust the magnitude of the magneticfield.

The scalability of the magnetic field to the total electrical current inthe example of Table 1 is also shown in the plot of FIG. 27, where BZ isthe magnetic field along the Z-dimension; and R is the radial distancemeasured from a geometric center of the coil rings along a directionperpendicular to the Z-dimension. The magnetic field has the highestvalue at the geometric center, and decreases as the distance Rincreases. The curves 1035, 1037 represent the magnetic field generatedby the same coil sets receiving different total electrical current: 1760Amperes and 1990 Amperes, respectively. The corresponding energies ofthe extracted particles are 211 MeV and 250 MeV, respectively. The twocurves 1035, 1037 have substantially the same shape and the differentparts of the curves 1035, 1037 are substantially parallel. As a result,either the curve 1035 or the curve 1037 can be linearly shifted tosubstantially match the other curve, indicating that the magnetic fieldis scalable to the total electrical current applied to the coil sets.

In some implementations, the scalability of the magnetic field to thetotal electrical current may not be perfect. For example, the ratiobetween the magnetic field and the current calculated based on theexample shown in table 1 is not constant. Also, as shown in FIG. 27, thelinear shift of one curve may not perfectly match the other curve. Insome implementations, the total current is applied to the coil setsunder the assumption of perfect scalability. The target magnetic field(under the assumption of perfect scalability) can be generated byadditionally altering the features, e.g., geometry, of the coils tocounteract the imperfection in the scalability. As one example,ferromagnetic (e.g., iron) rods (magnetic shims) can be inserted orremoved from one or both of the magnetic structures (e.g., yokes, polepieces, and the like). The features of the coils can be altered at arelatively high rate so that the rate of the magnetic field adjustmentis not substantially affected as compared to the situation in which thescalability is perfect and only the electrical current needs to beadjusted. In the example of iron rods, the rods can be added or removedat the time scale of seconds or minutes, e.g., within 5 minutes, within1 minute, less than 30 seconds, or less than 1 second.

In some implementations, settings of the accelerator, such as thecurrent applied to the coil sets, can be chosen based on the substantialscalability of the magnetic field to the total electrical current in thecoil sets.

Generally, to produce the total current that varies within a desiredrange, any appropriate combination of current applied to the two coilsets can be used. In an example, the coil set 42 a, 42 b can beconfigured to receive a fixed electrical current corresponding to alower boundary of a desired range of the magnetic field. In the exampleshown in table 1, the fixed electrical current is 1760 Amperes. Inaddition, the coil set 40 a, 40 b can be configured to receive avariable electrical current having an upper boundary corresponding to adifference between an upper boundary and a lower boundary of the desiredrange of the magnetic field. In the example shown in table 1, the coilset 40 a, 40 b is configured to receive electrical current that variesbetween 0 Ampere and 230 Amperes.

In another example, the coil set 42 a, 42 b can be configured to receivea fixed electrical current corresponding to an upper boundary of adesired range of the magnetic field. In the example shown in table 1,the fixed current is 1990 Amperes. In addition, the coil set 40 a, 40 bcan be configured to receive a variable electrical current having anupper boundary corresponding to a difference between a lower boundaryand an upper boundary of the desired range of the magnetic field. In theexample shown in table 1, the coil set 40 a, 40 b is configured toreceive electrical current that varies between −230 Ampere and 0 Ampere.

The total variable magnetic field generated by the variable totalcurrent for accelerating the particles can have a maximum magnitudegreater than 4 Tesla, e.g., greater than 5 Tesla, greater than 6 Tesla,greater than 7 Tesla, greater than 8 Tesla, greater than 9 Tesla, orgreater than 10 Tesla, and up to about 20 Tesla or higher, e.g., up toabout 18 Tesla, up to about 15 Tesla, or up to about 12 Tesla. In someimplementations, variation of the total current in the coil sets canvary the magnetic field by about 0.2 Tesla to about 4.2 Tesla or more,e.g., about 0.2 Tesla to about 1.4 Tesla or about 0.6 Tesla to about 4.2Tesla. In some situations, the amount of variation of the magnetic fieldcan be proportional to the maximum magnitude.

FIG. 28 shows an example RF structure for sweeping the voltage on thedee plate 500 over an RF frequency range for each energy level of theparticle beam, and for varying the frequency range when the particlebeam energy is varied. The semicircular surfaces 503, 505 of the deeplate 500 are connected to an inner conductor 1300 and housed in anouter conductor 1302. The high voltage is applied to the dee plate 500from a power source (not shown, e.g., an oscillating voltage input)through a power coupling device 1304 that couples the power source tothe inner conductor. In some implementations, the coupling device 1304is positioned on the inner conductor 1300 to provide power transfer fromthe power source to the dee plate 500. In addition, the dee plate 500 iscoupled to variable reactive elements 1306, 1308 to perform the RFfrequency sweep for each particle energy level, and to change the RFfrequency range for different particle energy levels.

The variable reactive element 1306 can be a rotating capacitor that hasmultiple blades 1310 rotatable by a motor (not shown). By meshing orunmeshing the blades 1310 during each cycle of RF sweeping, thecapacitance of the RF structure changes, which in turn changes theresonant frequency of the RF structure. In some implementations, duringeach quarter cycle of the motor, the blades 1310 mesh with the eachother. The capacitance of the RF structure increases and the resonantfrequency decreases. The process reverses as the blades 1310 unmesh. Asa result, the power required to generate the high voltage applied to thedee plate 103 and necessary to accelerate the beam can be reduced by alarge factor. In some implementations, the shape of the blades 1310 ismachined to form the required dependence of resonant frequency on time.

The RF frequency generation is synchronized with the blade rotation bysensing the phase of the RF voltage in the resonator, keeping thealternating voltage on the dee plates close to the resonant frequency ofthe RF cavity. (The dummy dee is grounded and is not shown in FIG. 28).

The variable reactive element 1308 can be a capacitor formed by a plate1312 and a surface 1316 of the inner conductor 1300. The plate 1312 ismovable along a direction 1314 towards or away from the surface 1316.The capacitance of the capacitor changes as the distance D between theplate 1312 and the surface 1316 changes. For each frequency range to beswept for one particle energy, the distance D is at a set value, and tochange the frequency range, the plate 1312 is moved corresponding to thechange in the energy of the output beam.

In some implementations, the inner and outer conductors 1300, 1302 areformed of a metallic material, such as copper, aluminum, or silver. Theblades 1310 and the plate 1312 can also be formed of the same ordifferent metallic materials as the conductors 1300, 1302. The couplingdevice 1304 can be an electrical conductor. The variable reactiveelements 1306, 1308 can have other forms and can couple to the dee plate100 in other ways to perform the RF frequency sweep and the frequencyrange alteration. In some implementations, a single variable reactiveelement can be configured to perform the functions of both the variablereactive elements 1306, 1308. In other implementations, more than twovariable reactive elements can be used.

The control of the gantry, the patient support, the active beam shapingelements, and the synchrocyclotron to perform a therapy session isachieved by appropriate therapy control electronics (not shown).

Control of the particle therapy system described herein and its variousfeatures may be implemented using hardware or a combination of hardwareand software. For example, a system like the ones described herein mayinclude various controllers and/or processing devices located at variouspoints. A central computer may coordinate operation among the variouscontrollers or processing devices. The central computer, controllers,and processing devices may execute various software routines to effectcontrol and coordination of testing and calibration.

System operation can be controlled, at least in part, using one or morecomputer program products, e.g., one or more computer program tangiblyembodied in one or more non-transitory machine-readable media, forexecution by, or to control the operation of, one or more dataprocessing apparatus, e.g., a programmable processor, a computer,multiple computers, and/or programmable logic components.

A computer program can be written in any form of programming language,including compiled or interpreted languages, and it can be deployed inany form, including as a stand-alone program or as a module, component,subroutine, or other unit suitable for use in a computing environment. Acomputer program can be deployed to be executed on one computer or onmultiple computers at one site or distributed across multiple sites andinterconnected by a network.

Actions associated with implementing all or part of the operations ofthe particle therapy system described herein can be performed by one ormore programmable processors executing one or more computer programs toperform the functions described herein. All or part of the operationscan be implemented using special purpose logic circuitry, e.g., an FPGA(field programmable gate array) and/or an ASIC (application-specificintegrated circuit).

Processors suitable for the execution of a computer program include, byway of example, both general and special purpose microprocessors, andany one or more processors of any kind of digital computer. Generally, aprocessor will receive instructions and data from a read-only storagearea or a random access storage area or both. Elements of a computer(including a server) include one or more processors for executinginstructions and one or more storage area devices for storinginstructions and data. Generally, a computer will also include, or beoperatively coupled to receive data from, or transfer data to, or both,one or more machine-readable storage media, such as mass PCBs forstoring data, e.g., magnetic, magneto-optical disks, or optical disks.Non-transitory machine-readable storage media suitable for embodyingcomputer program instructions and data include all forms of non-volatilestorage area, including by way of example, semiconductor storage areadevices, e.g., EPROM, EEPROM, and flash storage area devices; magneticdisks, e.g., internal hard disks or removable disks; magneto-opticaldisks; and CD-ROM and DVD-ROM disks.

Any “electrical connection” as used herein may imply a direct physicalconnection or a wired or wireless connection that includes interveningcomponents but that nevertheless allows electrical signals to flowbetween connected components. Any “connection” involving electricalcircuitry mentioned herein, unless stated otherwise, may be anelectrical connection and not necessarily a direct physical connectionregardless of whether the word “electrical” is used to modify“connection”.

Any two more of the foregoing implementations may be used in anappropriate combination in an appropriate particle accelerator (e.g., asynchrocyclotron). Likewise, individual features of any two more of theforegoing implementations may be used in an appropriate combination.

Elements of different implementations described herein may be combinedto form other implementations not specifically set forth above. Elementsmay be left out of the processes, systems, apparatus, etc., describedherein without adversely affecting their operation. Various separateelements may be combined into one or more individual elements to performthe functions described herein.

The example implementations described herein are not limited to use witha particle therapy system or to use with the example particle therapysystems described herein. Rather, the example implementations can beused in any appropriate system that directs accelerated particles to anoutput.

Other implementations not specifically described herein are also withinthe scope of the following claims.

What is claimed is: 1-19. (canceled)
 20. A method comprising: receiving,from a treatment planning process, information that is based on a dosedistribution for an irradiation target; and performing operationscomprising: moving structures to trim spots of a particle beam so thatthe spots of the particle beam approximate pre-trimmed spots for whichcharacteristics are obtained based on the information received.
 21. Themethod of claim 20, wherein the structures are part of a configurablecollimator and comprise leaves that are movable into, or out of, an areato be treated by the particle beam. 22-40. (canceled)
 41. A particletherapy system comprising: a particle accelerator to output a particlebeam for application to an irradiation target; and a control systemcomprising one or more processing devices configured to performoperations comprising: receiving, from a treatment planning process,information that is based on a dose distribution for the irradiationtarget; and performing operations comprising: moving structures to trimspots of the particle beam so that the spots of the particle beamapproximate pre-trimmed spots for which characteristics are obtainedbased on the information received.
 42. The particle therapy system ofclaim 41, wherein the particle therapy system further comprises aconfigurable collimator, the structures being part of the configurablecollimator and comprising leaves that are movable into, or out of, anarea to be treated by the particle beam. 43-46. (canceled)
 47. One ormore non-transitory machine-readable storage media storing instructionsthat are executable to perform operations comprising: obtaining a targetdose distribution for a treatment area; identifying one or morepre-trimmed spots from among a library of pre-trimmed spots that bestapproximates one or more points of the target dose distribution; andoutputting information identifying the one or more pre-trimmed spots.48. The one or more non-transitory machine-readable storage media ofclaim 47, wherein the operations comprise: obtaining a set of coarsespots that approximates the target dose distribution; changing anintensity of one or more spots in the coarse set based on a maximumacceptable dosage for a portion of the treatment area; identifying aspot among the coarse spots that is within a transition region of thetreatment area; and substituting the one or more pre-trimmed spots forthe spot within the transition region.
 49. The one or morenon-transitory machine-readable storage media of claim 48, wherein theoperations comprise: obtaining a minimum acceptable dosage for a portionof the treatment area; wherein the set of coarse spots is selected basedon the minimum acceptable dosage.
 50. The one or more non-transitorymachine-readable storage media of claim 47, wherein the information isusable to configure a configurable collimator to achieve a dosedistribution during treatment that approximates the target dosedistribution. 51-54. (canceled)
 55. The particle therapy system of claim41, wherein the information identifies characteristics of thepre-trimmed spots, the characteristics being stored in a library incomputer memory.
 56. The particle therapy system of claim 41, whereinthe information indicates where the pre-trimmed spots are to be formedon the irradiation target; and wherein the structures are part of aconfigurable collimator.
 57. The particle therapy system of claim 41,wherein the information identifies characteristics of the pre-trimmedspots; and wherein the structures are movable on a spot-by-spot basis.58. The particle therapy system of claim 57, wherein at least twosuccessive spots have at least one of a different size or a differentshape.
 59. The particle therapy system of claim 41, wherein theinformation comprises specifications of a trimming curve for a radiationfield associated with the irradiation target.
 60. The particle therapysystem of claim 41, further comprising: a configurable collimatorcomprising the structures, the configurable collimator comprising aprimary carriage coupled to the structures to move the structuresrelative to the irradiation target in a first dimension relative to theirradiation target; and wherein the control system is configured to movethe primary carriage to trim the spots.
 61. The particle therapy systemof claim 60, wherein the configurable collimator comprises secondarycarriages coupled to the primary carriage and to the structures to movethe structures in a second dimension relative to the irradiation target;and wherein the control system is configured to move at least one of thesecondary carriages to trim the spots.
 62. The particle therapy systemof claim 61, wherein the second dimension comprises movement into, andout of, a treatment area.
 63. The particle therapy system of claim 61,wherein moving at least one of the secondary carriages comprisesrotating the at least one secondary carriage.
 64. The particle therapysystem of claim 60, wherein the structures comprise leaves that areextendible and retractable relative to the particle beam.
 65. Theparticle therapy system of claim 60, wherein the control system isconfigured to rotate all or part of the configurable collimator.
 66. Themethod of claim 20, wherein at least two successive spots have at leastone of a different size or a different shape.